Grant: Operating Grant

Many children admitted to intensive care experience injury to their kidneys. This occurs because of the condition that affects them or the interventions they undergo, for example open heart surgery. Severe kidney injury in the intensive care unit leads to many problems, like fluid retention and heart failure and sometimes requires dialysis. Although we know that kidney injury has effects on various short term outcomes (length of hospital stay and risk of death) we know very little about how this kidney injury occurring in hospital affects children in the long term. Chronic kidney disease (CKD) is a significant burden of illness in populations across the world including those in Canada. Early lifetime events such as kidney injury during critical illness may be an important risk factor for CKD. Early treatment and prevention of this injury could lead to significant improvements in outcomes for individuals and decrease burden of this condition to the health care system. We therefore need to clarify if children admitted to the intensive care unit with kidney injury develop CKD. We also need to determine if traditional tests of kidney function are useful for detecting CKD in children who have recovered from kidney injury in the intensive care unit. We will follow-up children from 3 previously-studied North American groups of children who were admitted to the intensive care unit. We will evaluate if they have developed signs of CKD at 6 year follow-up. We will also explore new and hopefully better tests for detecting CKD at follow-up. By showing the long term effects of acute kidney injury in children and evaluating possible risk factors for these outcomes, this study will help direct future treatment studies. Our results will also allow us to make recommendations on how to follow-up kidney function in children after they have been critically ill.