ArticleAmerican journal of respiratory and critical care medicine2019
Identification of Acute Kidney Injury Subphenotypes with Differing Molecular Signatures and Responses to Vasopressin Therapy.
Article in American journal of respiratory and critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
108 citing papers in PubMed, 1 synthesis or guideline pooled it, 203 citations in OpenAlex.
- Methods for phenotyping adult patients with acute kidney injury: a systematic review.Journal of nephrology · 2025Pooled it
- Molecular Phenotyping of Sepsis and Differential Response to Fluid Resuscitation.American journal of respiratory and critical care medicine · 2025Trial
- Biochemical phenotypes of acute kidney injury and their association with major adverse kidney events.Renal failure · 2026Article
- Insights from integrative spatial transcriptomics in sepsis-associated acute kidney injury.Nature reviews. Nephrology · 2026Review
- Targeting integrated cell death networks in sepsis‑associated acute kidney injury: Shared regulatory nodes and diet‑related small molecule modulation (Review).International journal of molecular medicine · 2026Review
- Machine learning phenotypes and heterogeneous albumin effects in cirrhotic AKI: a causal inference study.Internal and emergency medicine · 2026Article
- Flow Cytometry and AI-Driven Biomarker Discovery in Acute Kidney Injury: From Mechanistic Insights to Translation Applications in Clinical and Austere Environments.International journal of molecular sciences · 2026Review
- Protein Quantification Platforms For Use In Critical Care Precision Medicine Trials: A Scoping Review.Critical care explorations · 2026Article
- Endothelial biomarkers predict kidney and cardiovascular outcomes after acute kidney injury.Clinical kidney journal · 2026Article
- Precision medicine in pediatric sepsis-associated acute kidney injury: when systemic heterogeneity meets organ-level heterogeneity.World journal of pediatrics : WJP · 2026Article
- Pediatric sepsis-associated acute kidney injury: leveraging pathophysiology for risk stratification and identification of treatable traits.Pediatric nephrology (Berlin, Germany) · 2026Review
- Comparative efficacy and safety of anticoagulation strategies in continuous renal replacement therapy: a real-world cohort study.BMC nephrology · 2026Article
- External Validation, Molecular Signatures, and Therapeutic Relevance of Pediatric Sepsis-Associated Acute Kidney Injury Subphenotypes.Critical care medicine · 2026Observational
- Article
- Biomarker-Based Diagnosis and Risk Stratification in Sepsis-Associated Acute Kidney Injury: From Molecular Mechanisms to Multimarker Panels.Diagnostics (Basel, Switzerland) · 2026Review
- Association of Serum Angiopoietin-2 With Kidney Function Decline Among Participants in the Multiethnic Study of Atherosclerosis (MESA) Cohort.Kidney medicine · 2026Article
- Shared multicellular injury programs of acute and chronic kidney disease enable mechanistic patient stratification.medRxiv : the preprint server for health sciences · 2026Article
- Pathophysiology and Management of Sepsis-associated Acute Kidney Injury.Clinics in chest medicine · 2026Review
- Artificial Intelligence in Critical Care Nephrology: Current Applications, Emerging Techniques, and Challenges to Clinical Integration.Kidney360 · 2026Review
- Transforming nephrology through artificial intelligence: a state-of-the-art roadmap for clinical integration.Clinical kidney journal · 2026Review
48 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
21 authors at 10 institutions in 4 countries.
Funding
Abstract
rationaleCurrently, no safe and effective pharmacologic interventions exist for acute kidney injury (AKI). One reason may be that heterogeneity exists within the AKI population, thereby hampering the identification of specific pathophysiologic pathways and therapeutic targets.
objectiveThe aim of this study was to identify and test whether AKI subphenotypes have prognostic and therapeutic implications.
methodsFirst, latent class analysis methodology was applied independently in two critically ill populations (discovery [n = 794] and replication [n = 425]) with AKI. Second, a parsimonious classification model was developed to identify AKI subphenotypes. Third, the classification model was applied to patients with AKI in VASST (Vasopressin and Septic Shock Trial; n = 271), and differences in treatment response were determined. In all three populations, AKI was defined using serum creatinine and urine output. MEASUREMENTS AND MAIN
resultsA two-subphenotype latent class analysis model had the best fit in both the discovery (P = 0.004) and replication (P = 0.004) AKI groups. The risk of 7-day renal nonrecovery and 28-day mortality was greater with AKI subphenotype 2 (AKI-SP2) relative to AKI subphenotype 1 (AKI-SP1). The AKI subphenotypes discriminated risk for poor clinical outcomes better than the Kidney Disease: Improving Global Outcomes stages of AKI. A three-variable model that included markers of endothelial dysfunction and inflammation accurately determined subphenotype membership (C-statistic 0.92). In VASST, vasopressin compared with norepinephrine was associated with improved 90-day mortality in AKI-SP1 (27% vs. 46%, respectively; P = 0.02), but no significant difference was observed in AKI-SP2 (45% vs. 49%, respectively; P = 0.99) and the P value for interaction was 0.05.
conclusionsThis analysis identified two molecularly distinct AKI subphenotypes with different clinical outcomes and responses to vasopressin therapy. Identification of AKI subphenotypes could improve risk prognostication and may be useful for predictive enrichment in clinical trials.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.