Evidence map›Paper›PMID 34419950›Full record

ArticleNephron2021

Comparison of Static and Dynamic Baseline Creatinine Surrogates for Defining Acute Kidney Injury.

David G Warnock, Javier A Neyra, Etienne Macedo, Ayme D Miles, Ravindra L Mehta, Christoph Wanner

Open access · greenAbstract readComparative Study
In one paragraph

Article in Nephron, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 34% 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

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
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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

6 authors at 4 institutions in 2 countries.

David G WarnockDepartment of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Javier A NeyraDepartment of Medicine, University of Kentucky, Lexington, Massachusetts, USA.
Etienne MacedoDepartment of Medicine, University of California at San Diego, San Diego, California, USA.
Ayme D MilesInformatics Institute, HSIS, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Ravindra L MehtaDepartment of Medicine, University of California at San Diego, San Diego, California, USA.
Christoph WannerDepartment of Nephrology, University of Würzburg, Würzburg, Germany.
University of Alabama at Birmingham · USUniversity of California, San Diego · USUniversity of Kentucky · USUniversity of Würzburg · DE

Funding

Kentucky Center for Clinical and Translational ScienceUL1TR001998 · NCATS · UNIVERSITY OF KENTUCKY · PI HARTMANN, KATHERINE E, KERN, PHILIP A · 2016 to 2025
$34.2M
UAB Center for Clinical and Translational Science (CCTS)UL1TR001417 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KIMBERLY, ROBERT P. · 2015 to 2018
$31.4M
UAB-UCSD O'Brien Core Center for Acute Kidney Injury ResearchP30DK079337 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI AGARWAL, ANUPAM · 2008 to 2022
$18.3M
NCATS NIH HHS UL1 TR001417NCATS NIH HHS UL1 TR001998NIDDK NIH HHS P30 DK079337
6 · The paper itself

Abstract

background"Dynamic" baseline serum creatinine (sCr), based on a rolling 48-h window, and a static baseline sCr (previous outpatient sCr) were used to define acute kidney injury (AKI).

methodsRetrospective cohort study of adult admissions to the University of Alabama (UAB) Health System hospitals for years 2016-2018. Included admissions had >1- and <180-day length of stay, >2 inpatient sCr measurements, and an averaged estimated glomerular filtration rate >15 mL/min/1.73 m2. The final cohort of 62,380 patients included 100,570 admissions, 3,509 inpatient deaths, and 1,916 admissions with inpatient dialysis. AKI was defined by Kidney Disease Improving Global Outcomes (KDIGO) criteria and a static or dynamic baseline sCr. Discrimination was evaluated with area under receiver operator curves (AUC), logistic regression, and net reclassification improvement (NRI).

resultsPreadmission outpatient "static" sCr values were available for 43,433 admissions. The lowest sCr value during a rolling 48-h window before each inpatient sCr defined a "dynamic" baseline sCr. Using point-wise comparisons, the dynamic baseline sCr performed better than static baseline sCr for inpatient mortality (AUC [0.819 vs. 0.741; p < 0.001] and NRI ≥0.306 [p < 0.001]) and inpatient dialysis (AUC [0.903 vs. 0.864; p < 0.001] and NRI ≥0.317 [p < 0.001]).

conclusionsThe dynamic baseline sCr is available without reference to preadmission sCr values and avoids confounding associated with missing outpatient sCr values. AKI defined with the dynamic baseline sCr significantly improved discrimination of risk for inpatient mortality and dialysis compared to static baseline sCr.

Indexed as

Acute Kidney InjuryAdultAgedCreatinineFemaleGlomerular Filtration RateHumansMaleMiddle AgedPatient AdmissionRenal Replacement TherapyRetrospective StudiesCreatinineBaseline serum creatinineCreatinine trajectoryKidney Disease Improving Global Outcomes acute kidney injury definitionSerum creatinine

Identifiers

PMID34419950
PMCPMC8595494
OpenAlexW3193962049

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.