ArticleCritical care (London, England)2016
Acute kidney injury subphenotypes based on creatinine trajectory identifies patients at increased risk of death.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05247502 (Impact of the Characteristics of Acute Renal Failure in Intensive Care on the Long-term Renal Prognosis), which is not on this map. Cited by 53 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of the Characteristics of Acute Renal Failure in Intensive Care on the Long-term Renal Prognosis: Prospective Multicenter Cohort Study
Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Methods for phenotyping adult patients with acute kidney injury: a systematic review.Journal of nephrology · 2025Pooled it
- Inclusion and definition of acute renal dysfunction in critically ill patients in randomized controlled trials: a systematic review.Critical care (London, England) · 2018Pooled it
- The ABO histo-blood group, endothelial activation, and acute respiratory distress syndrome risk in critical illness.The Journal of clinical investigation · 2021Trial
- Association between early body temperature dynamic trajectory and mortality and infection rates for patients with cardiac arrest in ICU: a retrospective study.Journal of thoracic disease · 2026Article
- Early Total Bilirubin Trajectories During the First 72 Hours After ICU Admission With Mechanical Ventilation and Short-Term Mortality: A Multicenter Cohort Study.Critical care explorations · 2026Observational
- Deep-learning time-series anomaly detection of acute kidney injury from creatinine-eGFR trajectories in the ICU.PLOS digital health · 2026Article
- Integrating 72-h BUN/Cr trajectories with interpretable machine learning for 28-day mortality after acute stroke: a dual-center landmark study.Frontiers in neurology · 2026Article
- Exploring trajectories of acute kidney injury in the intensive care unit: a population-based cohort study.Scientific reports · 2025Article
- Clustering analysis of multi-site electronic health records reveals distinct subphenotypes in stage-1 acute kidney injury.Communications medicine · 2025Article
- Machine learning-derived multivariate renal function trajectories in acute kidney injury in critically ill patients: a multicentre retrospective study.Clinical kidney journal · 2025Article
- The Furosemide Stress Test: A Dynamic Tool for Predicting Acute Kidney Injury Progression in Critical Care Medicine.Journal of clinical medicine · 2025Review
- Acute Kidney Injury Provider and Survivor Education: Current and Emerging Tools.Advances in kidney disease and health · 2025Review
- Renal mitochondria response to sepsis: a sequential biopsy evaluation of experimental porcine model.Intensive care medicine experimental · 2025Article
- [Clinical sub-phenotypes of acute kidney injury in children and their association with prognosis].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025Article
- A promising application of kidney-specific cell-free DNA methylation markers in real-time monitoring sepsis-induced acute kidney injury.Epigenetics · 2024Article
- Development and validation of a deep learning algorithm for the prediction of serum creatinine in critically ill patients.JAMIA open · 2024Article
- The Role of Oxidative Stress as a Mechanism in the Pathogenesis of Acute Heart Failure in Acute Kidney Injury.Diagnostics (Basel, Switzerland) · 2024Review
- Machine learning derived serum creatinine trajectories in acute kidney injury in critically ill patients with sepsis.Critical care (London, England) · 2024Article
- Influence of acute kidney injury and its recovery subtypes on patient-centered outcomes after lung transplantation.Scientific reports · 2024Article
- Identifying novel acute pancreatitis sub-phenotypes using total serum calcium trajectories.BMC gastroenterology · 2024Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundAcute kidney injury (AKI) is common among intensive care unit (ICU) patients. AKI is highly heterogeneous, with variable links to poor outcomes. Current approaches to classify AKI severity and identify patients at highest risk for poor outcomes focus on the maximum change in serum creatinine (SCr) values. However, these scores are hampered by the need for a reliable baseline SCr value and the absence of a component differentiating transient from persistent rises in SCr. We hypothesized that identification of resolving or nonresolving AKI subphenotypes based on the early trajectory of SCr values in the ICU would better differentiate patients at risk of hospital mortality.
methodsWe performed a secondary analysis of two prospective studies of ICU patients admitted to a trauma ICU (group 1; n = 1914) or general medical-surgical ICUs (group 2; n = 1867). In group 1, we tested definitions for resolving and nonresolving AKI subphenotypes and selected the definitions resulting in subphenotypes with the greatest separation in risk of death relative to non-AKI controls. We applied this definition to group 2 and tested whether the subphenotypes were independently associated with hospital mortality after adjustment for AKI severity.
resultsAKI occurred in 46% and 69% of patients in groups 1 and 2, respectively. In group 1, a resolving AKI subphenotype (defined as a decrease in SCr of 0.3 mg/dl or 25% from maximum in the first 72 h of study enrollment) was associated with a low risk of death. A nonresolving AKI subphenotype (defined as all AKI cases not meeting the "resolving" definition) was associated with a high risk of death. In group 2, the resolving AKI subphenotype was not associated with increased mortality (relative risk [RR] 0.86, 95% CI 0.63-1.17), whereas the nonresolving AKI subphenotype was associated with higher mortality (RR 1.68, 95% CI 1.15-2.44) even after adjustment for AKI severity stage.
conclusionsThe trajectory of SCr levels identifies AKI subphenotypes with different risks for death, even among AKI cases of similar severity. These AKI subphenotypes might better define the patients at risk for poor outcomes who might benefit from novel interventions.
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