Evidence map›Paper›PMID 37359983›Full record

ArticleCanadian journal of kidney health and disease2023

Perspectives of Pediatric Nephrologists, Intensivists and Nurses Regarding AKI Management and Expected Outcomes.

Adrian Che, David D'Arienzo, Allison Dart, Cherry Mammen, Susan Samuel, Todd Alexander, Catherine Morgan, Tom Blydt-Hansen, Patricia Fontela, Gonzalo Garcia Guerra and 8 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of kidney health and disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 39% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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

18 authors at 8 institutions in 1 country.

Adrian CheThe Hospital for Sick Children, University of Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-1130-4507
David D'ArienzoFaculty of Medicine, McGill University, Montreal, QC, Canada.
Allison DartDepartment of Pediatrics and Child Health, Max Rady College of Medicine, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada.ORCID https://orcid.org/0000-0002-4718-9408
Cherry MammenDivision of Nephrology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, Canada.
Susan SamuelDepartment of Pediatrics, Section of Pediatric Nephrology, Alberta Children's Hospital, University of Calgary, Canada.
Todd AlexanderDepartment of Pediatrics, University of Alberta, Edmonton, Canada.ORCID https://orcid.org/0000-0001-7396-7894
Catherine MorganDepartment of Pediatrics, University of Alberta, Edmonton, Canada.
Tom Blydt-HansenPediatric Nephrology, BC Children's Hospital, The University of British Columbia, Vancouver, Canada.
Patricia FontelaDepartment of Pediatrics, McGill University, Montreal, QC, Canada.
Gonzalo Garcia GuerraIntensive Care Unit, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.
Rahul ChanchlaniDivision of Nephrology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
Stella WangThe Hospital for Sick Children, University of Toronto, ON, Canada.
Vedran CockovskiThe Hospital for Sick Children, University of Toronto, ON, Canada.
Natasha JawaThe Hospital for Sick Children, University of Toronto, ON, Canada.
Jasmine LeeThe Hospital for Sick Children, University of Toronto, ON, Canada.
Sophia NunesThe Hospital for Sick Children, University of Toronto, ON, Canada.
Stephanie ReynaudThe Hospital for Sick Children, University of Toronto, ON, Canada.
Michael ZappitelliDivision of Pediatric Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
University of Toronto · CAUniversity of Alberta · CAMcGill University · CAUniversity of British Columbia · CAChildren's Hospital Research Institute of Manitoba · CAHospital for Sick Children · CAMcMaster University · CAUniversity of Calgary · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute kidney injury (AKI) in critically ill children is associated with increased risk for short- and long-term adverse outcomes. Currently, there is no systematic follow-up for children who develop AKI in intensive care unit (ICU). Objective: This study aimed to assess variation regarding management, perceived importance, and follow-up of AKI in the ICU setting within and between healthcare professional (HCP) groups. Design: Anonymous, cross-sectional, web-based surveys were administered nationally to Canadian pediatric nephrologists, pediatric intensive care unit (PICU) physicians, and PICU nurses, via professional listservs. Setting: All Canadian pediatric nephrologists, PICU physicians, and nurses treating children in the ICU were eligible for the survey. Patients: N/A. Measurements: Surveys included multiple choice and Likert scale questions on current practice related to AKI management and long-term follow-up, including institutional and personal practice approaches, and perceived importance of AKI severity with different outcomes. Methods: Descriptive statistics were performed. Categorical responses were compared using Chi-square or Fisher's exact tests; Likert scale results were compared using Mann-Whitney and Kruskal-Wallis tests. Results: Surveys were completed by 34/64 (53%) pediatric nephrologists, 46/113 (41%) PICU physicians, and 82 PICU nurses (response rate unknown). Over 65% of providers reported hemodialysis to be prescribed by nephrology; a mix of nephrology, ICU, or a shared nephrology-ICU model was reported responsible for peritoneal dialysis and continuous renal replacement therapy (CRRT). Severe hyperkalemia was the most important renal replacement therapy (RRT) indication for both nephrologists and PICU physicians (Likert scale from 0 [not important] to 10 [most important]; median = 10, 10, respectively). Nephrologists reported a lower threshold of AKI for increased mortality risk; 38% believed stage 2 AKI was the minimum compared to 17% of PICU physicians and 14% of nurses. Nephrologists were more likely than PICU physicians and nurses to recommend long-term follow-up for patients who develop any AKI during ICU stay (Likert scale from 0 [none] to 10 [all patients]; mean=6.0, 3.8, 3.7, respectively) ( Limitations: Responses from all eligible HCPs in the country could not obtained. There may be differences in opinions between HCPs that completed the survey compared to those that did not. Additionally, the cross-sectional design of our study may not adequately reflect changes in guidelines and knowledge since survey completion, although no specific guidelines have been released in Canada since survey dissemination. Conclusions: Canadian HCP groups have variable perspectives on pediatric AKI management and follow-up. Understanding practice patterns and perspectives will help optimize pediatric AKI follow-up guideline implementation.

Indexed as

AKI (acute kidney injury)nephrologistsPICU nursePICU physiciansurvey

Identifiers

PMID37359983
PMCPMC10286545
OpenAlexW4380354002

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.