1205 Incidence of Acute Post Streptococcal Glomerulonephritis in Children
Archives of Disease in Childhood
Arch Dis Child 2012;97(Suppl 2):A1-A539 A345 Abstracts The statistical concordance between the definitions was evaluated using the Cohen's Kappa coefficient and their association with mortality using uni-and multivariable logistic regression. AKIdefinitions were adjusted for each other and for GA, BW and Apgar score. Results Among 263 VLBW infants, 28 (10.6%), 40 (15.2%) and 26 (9.9%) met the definition for AKI-1, AKI-2 and AKI-3 respectively. Low agreement was shown between AKI-1/AKI-2 (Kappa
... .43, 95%CI:0.27-0.59) and AKI-1/AKI-3 (Kappa 0.32, 95%CI:0.14-0.51). Substantial agreement was observed for AKI-2/AKI-3 (Kappa 0.69, 95%CI:0.56-0.82). 68/263 patients died (28.8%), with AKI-1 45.1%, AKI-2 32.5% and AKI-3 26.9% respectively. AKI patients run higher risk of death than the others (Crude OR 13.6 [P<0.001], 6.7 [P<0.001] and 3.8 [P0.007] for AKI-1, AKI-2 and AKI-3). Using multivariable model, AKI-1 and AKI-2 remained associated with higher mortality (OR 4.25 [P=0.008] and OR 3.70 [P=0.041]). Conclusions Different AKI-definitions lead to substantially different patients classifications. Even minimal increment of creatinine are associated with augmented risk of death among VLBW infants.