Evidence map›Paper›PMID 32152726›Full record

ArticlePediatric nephrology (Berlin, Germany)2020

Effects of hyperchloremia on renal recovery in critically ill children with acute kidney injury.

Matthew F Barhight, John T Brinton, Danielle E Soranno, Sarah Faubel, Peter M Mourani, Katja M Gist

Abstract read
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In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 25 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Hyperchloremia and acute kidney injury: chicken or the egg?Pediatric nephrology (Berlin, Germany) · 2023
    Article
  7. Association of hyperchloremia and acute kidney injury in pediatric patients with moderate and severe traumatic brain injury.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023
    Article
  8. Association of early dysnatremia with mortality in the neonatal intensive care unit: results from the AWAKEN study.Journal of perinatology : official journal of the California Perinatal Association · 2022
    Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Matthew F BarhightDivision of Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. mbarhight@luriechildrens.org.ORCID 0000-0002-1954-5823
John T BrintonDepartment of Biostatistics and Informatics, University of Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, USA.
Danielle E SorannoDivision of Pediatric Nephrology, Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
Sarah FaubelDivision of Renal Disease and Hypertension, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
Peter M MouraniDivision of Pediatric Critical Care Medicine, Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
Katja M GistDivision of Pediatric Cardiology, Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
University of Colorado Anschutz Medical Campus · USColorado School of Public Health · USNorthwestern University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSerum chloride derangements are associated with poor clinical outcomes, including acute kidney injury (AKI) and mortality. We sought to determine the association between persistent hyperchloremia and renal recovery in critically ill children with AKI.

methodsWe performed a retrospective cohort study of all patients with day 2 AKI admitted to a large academic pediatric intensive care unit from January 2014 to December 2015. After applying exclusion criteria, 348 patients were categorized as (1) hyperchloremia on both day 2 and day 7 (PersistentCl), (2) hyperchloremia on day 2 with normochloremia on day 7 (RecoveredCl), (3) normochloremia on day 2 with hyperchloremia on day 7 (DelayedCl), and (4) no hyperchloremia on day 2 nor day 7 (NormalCl). Hyperchloremia was defined as ≥ 110 mEq/L. The primary outcome was renal recovery on day 7, defined as the absence of AKI criteria. Secondary outcomes included discharge renal recovery, mortality, duration of mechanical ventilation, and hospital length of stay.

resultsDay 7 renal recovery rates for PersistentCl, RecoveredCl, DelayedCl, and NormalCl were 37%, 66%, 71%, and 52% respectively. PersistentCl had lower odds of day 7 renal recovery (aOR = 0.29; 95% CI, 0.14 to 0.60; p = 0.0009), lower odds of discharge renal recovery (aOR = 0.22; 95% CI, 0.11 to 0.48; p = 0.0001), and higher odds of mortality (aOR = 3.50; 95% CI, 1.11 to 11.10; p = 0.03) when compared with RecoveredCl after adjusting for confounders.

conclusionsPersistent hyperchloremia is independently associated with impaired renal recovery as well as higher mortality. Prospective studies are indicated to determine if serum chloride represents a modifiable risk factor for poor outcomes. Graphical abstract.

Indexed as

Acute Kidney InjuryAdolescentBicarbonatesChildChild, PreschoolChloridesFemaleHumansIntensive Care Units, PediatricMaleRetrospective StudiesWater-Electrolyte ImbalanceBicarbonatesChloridesAcute kidney diseaseAcute kidney injuryHyperchloremiaMortalityPediatricRenal recovery

Identifiers

PMID32152726
OpenAlexW3012291588

What OpenQuestion holds

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Registered trials

None linked

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.