Observational studyCritical care (London, England)2022
Comparison of diagnostic criteria for acute kidney injury in critically ill children: a multicenter cohort study.
Observational study in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses 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
29 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Novel biomarkers for acute kidney injury in high-risk pediatric populations: a systematic review.Renal failure · 2026Pooled it
- Incidence of acute kidney injury-associated mortality in hospitalized children: a systematic review and meta-analysis.BMC nephrology · 2025Pooled it
- The application of machine learning in predicting post-cardiac surgery acute kidney injury in pediatric patients: a systematic review.Frontiers in pediatrics · 2025Pooled it
- Low Serum Alkaline Phosphatase Levels in Paediatric sepsis Correlate With Acute Kidney Injury: A Multicenter Retrospective Study.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Adjunctive metolazone in critically ill children with moderate-to-severe acute kidney injury and furosemide-refractory fluid overload.Pediatric nephrology (Berlin, Germany) · 2026Article
- Comparison of diagnostic criteria for disseminated intravascular coagulation in critically ill children.Pediatric research · 2026Article
- US Pediatric Hospitalizations Complicated by Acute Kidney Injury and Dialysis From 1997 to 2022.JAMA network open · 2026Article
- HMGB1/MYH9 suppresses PPARγ to induce lung injury in renal ischemia-reperfusion: protective effects of Rosiglitazone.Pediatric research · 2026Article
- Systemic immune-inflammation index (SII): a predictor of mortality risk in pediatric acute kidney injury.Pediatric research · 2026Article
- Racial, Ethnic, and Neighborhood Disparities in Acute Kidney Injury in Pediatric Acute Leukemia.Cancer medicine · 2026Article
- Reference Change Value Based AKI Criteria in Critically Ill Children.Kidney international reports · 2026Article
- Optimization of Kidney Disease: Improving Global Outcomes Criteria for AKI for Pediatric Population.Kidney international reports · 2026Article
- A novel age-norm-capped baseline serum creatinine approach for acute kidney injury diagnosis in critically Ill children: a retrospective cohort study.Frontiers in pediatrics · 2026Article
- Dexmedetomidine improves septic acute kidney injury by inhibiting inflammation and oxidative stress through the activation of the Pink1/Park2 autophagy pathway.Renal failure · 2025Article
- Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis.Research square · 2025Article
- Risk of acute kidney injury following intravenous iodinated contrast exposure among pediatric population: a narrative review.Pediatric radiology · 2025Review
- The challenges for developing prognostic prediction models for acute kidney injury in hospitalized children: A systematic review.Pediatric investigation · 2025Review
- Utility of plasma suPAR to identify AKI and sepsis associated AKI in critically ill children.iScience · 2024Article
- Acute Kidney Injury in Neonatal Intensive Care Unit: Epidemiology, Diagnosis and Risk Factors.Journal of clinical medicine · 2024Review
- Meropenem Disposition in Neonatal and Pediatric Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy.Antibiotics (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundSubstantial interstudy heterogeneity exists in defining acute kidney injury (AKI) and baseline serum creatinine (SCr). This study assessed AKI incidence and its association with pediatric intensive care unit (PICU) mortality under different AKI and baseline SCr definitions to determine the preferable approach for diagnosing pediatric AKI.
methodsIn this multicenter prospective observational cohort study, AKI was defined and staged according to the Kidney Disease: Improving Global Outcome (KDIGO), modified KDIGO, and pediatric reference change value optimized for AKI (pROCK) definitions. The baseline SCr was calculated based on the Schwartz formula or estimated as the upper normative value (NormsMax), admission SCr (AdmSCr) and modified AdmSCr. The impacts of different AKI definitions and baseline SCr estimation methods on AKI incidence, severity distribution and AKI outcome were evaluated.
resultsDifferent AKI definitions and baseline SCr estimates led to differences in AKI incidence, from 6.8 to 25.7%; patients with AKI across all definitions had higher PICU mortality ranged from 19.0 to 35.4%. A higher AKI incidence (25.7%) but lower mortality (19.0%) was observed based on the Schwartz according to the KDIGO definition, which however was overcome by modified KDIGO (AKI incidence: 16.3%, PICU mortality: 26.1%). Furthermore, for the modified KDIGO, the consistencies of AKI stages between different baseline SCr estimation methods were all strong with the concordance rates > 90.0% and weighted kappa values > 0.8, and PICU mortality increased pursuant to staging based on the Schwartz. When the NormsMax was used, the KDIGO and modified KDIGO led to an identical AKI incidence (13.6%), but PICU mortality did not differ among AKI stages. For the pROCK, PICU mortality did not increase pursuant to staging and AKI stage 3 was not associated with mortality after adjustment for confounders.
conclusionsThe AKI incidence and staging vary depending on the definition and baseline SCr estimation method used. The modified KDIGO definition based on the Schwartz method leads AKI to be highly relevant to PICU mortality, suggesting that it may be the preferable approach for diagnosing AKI in critically ill children and provides promise for improving clinicians' ability to diagnose pediatric AKI.
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