ArticleKidney international reports2021
Recalibration of the Renal Angina Index for Pediatric Septic Shock.
Article in Kidney international reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Diagnostic accuracy of renal angina index alone or in combination with biomarkers for predicting acute kidney injury in children.Pediatric nephrology (Berlin, Germany) · 2022Pooled it
- Pediatric sepsis-associated acute kidney injury: leveraging pathophysiology for risk stratification and identification of treatable traits.Pediatric nephrology (Berlin, Germany) · 2026Review
- External Validation, Recalibration, and Extension of a Prediction Model of Early Acute Kidney Injury in Critically Ill Children Using Multicenter Data.Critical care explorations · 2026Article
- Advances in pediatric acute kidney injury detection and prediction: biomarkers and artificial intelligence.World journal of pediatrics : WJP · 2025Article
- Modification of the Cardiac Renal Angina Index for Predicting Adverse Kidney Events After Pediatric Cardiac Surgery.Journal of the American Heart Association · 2025Observational
- The challenges for developing prognostic prediction models for acute kidney injury in hospitalized children: A systematic review.Pediatric investigation · 2025Review
- The promise of biomarkers: precision medicine will pave a roadmap for pediatric acute kidney injury management in critically ill children.Intensive care medicine. Paediatric and neonatal · 2025Review
- 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
- Real-Time Acute Kidney Injury Risk Stratification-Biomarker Directed Fluid Management Improves Outcomes in Critically Ill Children and Young Adults.Kidney international reports · 2023Article
- External validation of the modified sepsis renal angina index for prediction of severe acute kidney injury in children with septic shock.Critical care (London, England) · 2023Observational
- Serum renin and prorenin concentrations predict severe persistent acute kidney injury and mortality in pediatric septic shock.Pediatric nephrology (Berlin, Germany) · 2023Observational
- Precision management of acute kidney injury in the intensive care unit: current state of the art.Intensive care medicine · 2023Review
- Acute kidney injury biomarker olfactomedin 4 predicts furosemide responsiveness.Pediatric nephrology (Berlin, Germany) · 2023Article
- Daily serum phosphate increase as early and reliable indicator of kidney injury in children with leukemia and lymphoma developing tumor lysis syndrome.Pediatric nephrology (Berlin, Germany) · 2023Article
- Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup.Nature reviews. Nephrology · 2023Review
- The renal angina index accurately predicts low risk of developing severe acute kidney injury among children admitted to a low-resource pediatric intensive care unit.Renal failure · 2023Observational
- Accuracy of the persistent AKI risk index in predicting acute kidney injury in patients admitted to the intensive care unit for acute respiratory failure.Critical care science · 2023Article
- Integration of the Renal Angina Index and Urine Neutrophil Gelatinase-Associated Lipocalin Improves Severe Acute Kidney Injury Prediction in Critically Ill Children and Young Adults.Kidney international reports · 2022Article
- Improving acute kidney injury diagnostic precision using biomarkers.Practical laboratory medicine · 2022Review
- The Challenge of Acute Kidney Injury Diagnostic Precision: From Early Prediction to Long-Term Follow-up.Kidney international reports · 2021Article
Corrections and comments
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Authors and funding
18 authors at 15 institutions in 1 country.
Funding
Abstract
introductionSepsis-associated acute kidney injury (AKI) is a common diagnosis in children that is associated with poor outcomes. The lack of therapeutic options once present makes early identification of at-risk patients essential. The renal angina index (RAI) has been previously validated to predict severe AKI in heterogeneous populations of critically ill children. The performance of this score specifically in children with septic shock is unknown.
methodsA secondary analysis of a multicenter, prospective, observational study of 379 children with septic shock to determine the ability of the RAI to predict severe AKI at day 3, and to assess for the potential need for recalibration of the RAI in this unique subset of patients.
resultsAt the original cutoff of ≥8, the RAI predicted day 3 severe AKI with an area under the receiving operating characteristic (AUROC) curve 0.90 (95% confidence interval [CI]: 0.86 to 93), 95% sensitivity, and 54% specificity. A Youden's index identified a higher optimal cutoff of ≥20 (sensitivity 83%, specificity 80%), and day 1 platelet count <150 × 10
conclusionsThe RAI appears to be a sensitive and reliable tool for prediction of severe AKI in children with septic shock, although the use of a recalibrated sepsis-specific RAI using a higher cutoff and platelet count may be beneficial.
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