Observational studyPediatric research2021
Clinical phenotypes of acute kidney injury are associated with unique outcomes in critically ill septic children.
Observational study in Pediatric research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Incidence of acute kidney injury-associated mortality in hospitalized children: a systematic review and meta-analysis.BMC nephrology · 2025Pooled it
- Comment on: "The impact of protein intake on kidney adverse events in critically ill patients: a systematic review and meta-analysis".International urology and nephrology · 2026Article
- Risk factors and predictive models for perioperative acute kidney injury in children: a narrative review.Translational pediatrics · 2026Review
- ZXDB Drives Macrophage Inflammatory Programming in Sepsis-Induced Acute Kidney Injury by Recruiting EIF4A3 to Enhance ACACA Translation.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Article
- Immune molecular mechanisms of PANoptosis in sepsis-induced acute kidney injury.Inflammation and regeneration · 2026Review
- Pathophysiology and Management of Sepsis-associated Acute Kidney Injury.Clinics in chest medicine · 2026Review
- Does hypoxemia aggravate sepsis-associated acute kidney injury? Integrated clinical and experimental evidence.Intensive care medicine experimental · 2025Article
- Acute kidney injury after lung transplantation: prediction, prevention, and management.Renal failure · 2025Review
- Malaria associated pathogenesis of chronic kidney disease (MAP-CKD): a prospective study of children hospitalized with severe malaria.BMC nephrology · 2025Article
- Renal resistive index by point of care ultrasound to predict sepsis associated acute kidney injury in critically ill children.Pediatric nephrology (Berlin, Germany) · 2024Observational
- Characteristics and Risk Factors for Pediatric Sepsis.Current medical science · 2024Article
- A proposed framework for advancing acute kidney injury risk stratification and diagnosis in children: a report from the 26th Acute Disease Quality Initiative (ADQI) conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Epidemiology of acute kidney injury in children: a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Elevated Activated Partial Thromboplastin Time as a Predictor of 28-Day Mortality in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Analysis.International journal of general medicine · 2024Article
- Acute kidney injury in pediatric toxic shock syndrome is associated with worse clinical course in the intensive care unit.European journal of pediatrics · 2023Observational
- Acute kidney injury biomarker olfactomedin 4 predicts furosemide responsiveness.Pediatric nephrology (Berlin, Germany) · 2023Article
- Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup.Nature reviews. Nephrology · 2023Review
- Consensus-Based Recommendations on Priority Activities to Address Acute Kidney Injury in Children: A Modified Delphi Consensus Statement.JAMA network open · 2022Article
- Olfactomedin 4 as a novel loop of Henle-specific acute kidney injury biomarker.Physiological reports · 2022Article
- Persistent But Not Transient Acute Kidney Injury Was Associated With Lower Transplant-Free Survival in Patients With Acute Liver Failure: A Multicenter Cohort Study.Critical care medicine · 2022Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAssessment of acute kidney injury (AKI) in septic patients remains imprecise. In adults, the classification of septic patients by clinical AKI phenotypes (severity and timing) demonstrates unique associations with patient outcome vs. broadly defined AKI.
methodsIn a multinational prospective observational study, AKI diagnosis in critically ill septic children was stratified by duration (transient vs. persistent) and severity (mild vs. severe by creatinine change and urine output). The outcomes of interest were mortality and intensive care unit resource complexity at 28 days.
resultsSeven hundred and fifty-seven septic children were studied (male 52.7%, age 4.6 years (1.5-11.9)). Mortality (overall 12.1%) was different between severe AKI and mild AKI (18.3 vs. 4.4%, p < 0.001) as well as intensive care unit (ICU) complexity (overall 34.5%, 45 vs. 21.7%, p < 0.001). Patients with Persistent AKI had fewer ICU-free days (17 (7, 21) vs. 24 (17, 26), p < 0.001) and higher ICU complexity (52.8 vs. 22.9%, p = 0.002) than transient AKI, even after exclusion of patients with early mortality. AKI phenotypes incorporating temporal and severity data correlate with unique survival (range 4.4-21.6%) and ICU-free days (range of 15-25 days)
conclusionsThe outcome of septic children with AKI changes by clinical phenotype. Our findings underscore the importance of prognostic enrichment in sepsis and AKI for the purpose of trial design and patient management. IMPACT: Although AKI occurs commonly in patients with sepsis (S-AKI), outcomes for children with S-AKI varies based on the severity and timing of the AKI. Existing S-AKI pediatric data utilize a broad singular definition of kidney injury. Increasing the precision of AKI classification results in a new understanding of how S-AKI associates with patient outcome. A refined classification of S-AKI identifies subgroups of children, making possible a targeted and a personalized medicine approach to S-AKI study and management.
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