Prognostic Value of Vitamin D Status in Pediatric Patients with Acute Kidney Injury in Tanta University Emergency Hospital, Egypt

Background: AKI is an independent predictor of morbidity and mortality for critically ill children at Pediatric Emergency Departement (PED) which are liable for vitamin D deficiency. It is proposed that vitamin D concentration may be either a biomarker or a co-factor of survival in PED. The aim of this work is to assess serum 25-(OH)D level in critically ill pediatric patients with AKI at PED within the 1st 24 hours of admission and evaluate its correlation with duration of hospital stay and mortality outcome.

Subjects and methods: This study was conducted upon 80 critically ill pediatric patients with AKI during the first 24 hours after hospital admission. AKI was diagnosed according to the Acute Kidney Injury Network (AKIN) criteria for serum creatinine. We analyzed the demographic data, PRISM III for severity of illness, CBC, CRP, serum Ca, serum Phosphorus, serum 25(OH)D and its correlations with studied variables. We compared between vitamin D severely deficient, insufficient and sufficient subgroup of patients.

Results: Vitamin D deficiency occurs in two third of studied patients versus one third of studied controls. There is a significant negative correlation between vitamin D level and age of patients, sepsis, death probability and serum phosphorus level, but there is a significant positive correlation between vitamin D level and serum calcium levels. There was statistically significant increase in death outcome with increased number of system failure, PRISM III score, decreased weight, height percentiles and sepsis, so they can be considered as predictors of mortality. ROC curves denote that 25 (OH) D levels are more valid than CRP in prediction of mortality.

Conclusion: Vitamin D deficiency was associated with higher incidence of sepsis and mortality.

Author(s): Mohamed A El-Gamasy, Mohsen M Eldeeb and Mohmed M. Abdelmageed

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