Advances in pediatric acute kidney injury

Raina, Rupesh; Chakraborty, Ronith; Tibrewal, Abhishek; Sethi, Sidharth Kumar; Bunchman, Timothy E.

doi:10.1038/s41390-021-01452-3

Cited by 18 publications

(11 citation statements)

References 91 publications

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“…Even mild AKI was associated with increased morbidity and mortality [ 14 , 15 ]. Several criteria have been described to define AKI in children, among which pRIFLE and KDIGO were the most commonly used in current practice [ 16 ]. Estimated creatinine clearance was used to define AKI according to pRIFLE [ 5 ], while KDIGO classification was based on the relative changes in SCr [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury after infant cardiac surgery: a comparison of pRIFLE, KDIGO, and pROCK definitions

Gao,

He,

Jin

et al. 2023

BMC Nephrol

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Background KDIGO and pRIFLE classifications are commonly used in pediatric acute kidney injury (AKI). As a novel AKI definition, pROCK considered the high variability of serum creatinine in children. This study aimed to compare the above three definitions for AKI in infants undergoing cardiac surgery. Methods We analyzed a clinical cohort of 413 infants undergoing cardiac surgery. AKI was defined and staged according to pRIFLE, KDIGO, and pROCK, respectively. Incidence differences and diagnostic agreement across definitions were assessed. The association between postoperative outcomes and AKI by each definition was investigated. Results Postoperative AKI was identified in 185 (44.8%), 160 (38.7%), and 77 (18.6%) patients according to pRIFLE, KDIGO, and pROCK, respectively. The agreement between pRIFLE and KDIGO was almost perfect (κ = 0.88), while there was only a slight agreement between pROCK and them. AKI by pROCK was independently associated with adverse outcomes (p = 0.003) and prolonged mechanical ventilation (p = 0.002). Conclusions There were considerable differences in AKI incidence and staging among definitions. Compared with pRIFLE and KDIGO, AKI defined by pROCK was significantly reduced and better associated with postoperative adverse outcomes.

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Section: Discussionmentioning

confidence: 99%

Acute kidney injury after infant cardiac surgery: a comparison of pRIFLE, KDIGO, and pROCK definitions

Gao,

He,

Jin

et al. 2023

BMC Nephrol

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“…Pediatric acute kidney injury (AKI) is common, especially in hospitalized children, its incidence being 18.7% overall and 24.4% among critically ill patients. 1 Children with AKI have increased odds of higher length of stay (LOS), death, hypertension, proteinuria, and chronic kidney disease. 1 , 2 Development of AKI increases health care costs and resource use burden.…”

Section: Introductionmentioning

confidence: 99%

“… 1 Children with AKI have increased odds of higher length of stay (LOS), death, hypertension, proteinuria, and chronic kidney disease. 1 , 2 Development of AKI increases health care costs and resource use burden. Despite the increasing incidence of pediatric AKI, 1 few studies have evaluated its US economic burden.…”

Section: Introductionmentioning

confidence: 99%

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Patterns in the Economic Burden of Acute Kidney Injury in Hospitalized Children, 2019-2021

et al. 2023

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“…These modalities have been shown to be especially effective in the case of fluid overload and preventing adverse outcomes and further renal decline. Advancements in biofilters can more specifically remove cytokines and endotoxins ( 2 ). Hybrid techniques such as sustained low-efficiency daily hemodiafiltration (SLED-f) allow for clearance of small as well as larger solutes and less need for anti-coagulants in critical children.…”

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confidence: 99%