Evidence map›Paper›PMID 32316994›Full record

Observational studyCritical care (London, England)2020

Different applications of the KDIGO criteria for AKI lead to different incidences in critically ill patients: a post hoc analysis from the prospective observational SICS-II study.

Renske Wiersema, Sakari Jukarainen, Ruben J Eck, Thomas Kaufmann, Jacqueline Koeze, Frederik Keus, Ville Pettilä, Iwan C C van der Horst, Suvi T Vaara

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03577405 (Simple Intensive Care Studies II), which is not on this map. Cited by 46 papers.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed
5.7field-weighted citation impact, top 3% 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.

NCT03577405 completednot on this map

Simple Intensive Care Studies II

Typeobservational_patient_registrySponsorUniversity Medical Center GroningenRan2018 to 2019Enrolled1,010ConditionsCritical Illness
3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 71 citations in OpenAlex.

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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

9 authors at 4 institutions in 2 countries.

Renske WiersemaDepartment of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. r.wiersema@umcg.nl.
Sakari JukarainenDivision of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Ruben J EckDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Thomas KaufmannDepartment of Anaesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Jacqueline KoezeDepartment of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Frederik KeusDepartment of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Ville PettiläDivision of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Iwan C C van der HorstDepartment of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Suvi T VaaraDivision of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
University Medical Center Groningen · NLHelsinki University Hospital · FIUniversity of Groningen · NLUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) is a frequent and clinically relevant problem in critically ill patients. Various randomized controlled trials (RCT) have attempted to assess potentially beneficial treatments for AKI. Different approaches to applying the Kidney Disease Improving Global Outcomes (KDIGO) criteria for AKI make a comparison of studies difficult. The objective of this study was to assess how different approaches may impact estimates of AKI incidence and whether the association between AKI and 90-day mortality varied by the approach used.

methodsConsecutive acutely admitted adult intensive care patients were included in a prospective observational study. AKI was determined following the KDIGO criteria during the first 7 days of ICU admission. In this post hoc analysis, we assessed whether AKI incidence differed when applying the KDIGO criteria in 30 different possible methods, varying in (A) serum creatinine (sCr), (B) urine output (UO), and (C) the method of combining these two into an outcome, e.g., severe AKI. We assessed point estimates and 95% confidence intervals for each incidence. Univariable regression was used to assess the associations between AKI and 90-day mortality.

resultsA total of 1010 patients were included. Baseline creatinine was available in 449 (44%) patients. The incidence of any AKI ranged from 28% (95%CI 25-31%) to 75% (95%CI 72-77%) depending on the approach used. Methods to estimate missing baseline sCr caused a variation in AKI incidence up to 15%. Different methods of handling UO caused a variation of up to 35%. At 90 days, 263 patients (26%) had died, and all 30 variations were associated with 90-day mortality.

conclusionsIn this cohort of critically ill patients, AKI incidence varied from 28 to 75%, depending on the method used of applying the KDIGO criteria. A tighter adherence to KDIGO definitions is warranted to decrease the heterogeneity of AKI and increase the comparability of future studies.

Indexed as

Acute Kidney InjuryAdultAgedAged, 80 and overCohort StudiesCreatinineFemaleHumansIncidenceIntensive Care UnitsMaleMiddle AgedProspective StudiesRegistriesSeverity of Illness IndexUrineCreatinineAcute kidney injuryCritically illEpidemiologyHeterogeneityMortalityRandomized controlled trials

Identifiers

PMID32316994
PMCPMC7175574
OpenAlexW3017033165

What OpenQuestion holds

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LicenceCC BY
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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.