Quality of life following hospitalization-associated acute kidney injury in children

Kelsey L. Richardson, R. Scott Watson, Sangeeta Hingorani

Acute kidney injury (AKI) is common in hospitalized children. The impact of AKI following hospitalization is not fully understood, particularly the impact on health related quality of life (HRQOL). The goal of this study was to determine the relationship between hospitalization-associated AKI and HRQOL in a pediatric population. We conducted a retrospective cohort study of children with hospitalization-associated AKI. Eligible children were 1-19 years old with AKI defined by kidney disease improving global outcomes (KDIGO) criteria and had at least one completed pediatric quality of life (PedsQL) 4.0 Generic Core Scale survey (N = 139). Participants completed up to three surveys to reflect baseline, admission and follow-up status. We categorized children as having mild AKI (KDIGO stage 1, N = 73) or severe AKI (KDIGO stage 2 or 3, N = 66). Mean PedsQL scores were compared by AKI group. Those with both baseline and follow-up surveys were analyzed to determine the proportion who returned to their baseline level of function within 8 weeks of discharge. Children with mild and severe AKI had similar baseline and admission PedsQL scores. Although children with severe AKI had lower follow-up scores, the results were not statistically significant (78.9 vs. 85.8, p = 0.11). Of those with severe AKI, 48% returned to their baseline level of physical functioning by follow-up, compared to 73% with mild AKI (p = 0.05). This is the first study of HRQOL following hospitalization-associated AKI. We found that children with severe AKI had depressed physical functioning after discharge when compared to children with mild AKI.