ArticleKidney international reports2023
Real-Time Acute Kidney Injury Risk Stratification-Biomarker Directed Fluid Management Improves Outcomes in Critically Ill Children and Young Adults.
Article in Kidney international reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis that pooled it.
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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.
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
54 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Machine learning for the prediction of acute kidney injury post cardiac surgery: a systematic review and meta-analysis.BMC medical informatics and decision making · 2026Pooled it
- Time Course of Kidney Injury Biomarkers in Children With Septic Shock: Nested Cohort Study Within the Pragmatic Pediatric Trial of Balanced Versus Normal Saline Fluid in Sepsis Trial.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025Trial
- Fluid accumulation and outcomes in children receiving continuous kidney replacement therapy: an appraisal of the WE-ROCK registry.Pediatric nephrology (Berlin, Germany) · 2026Article
- Time from acute kidney injury to continuous renal replacement therapy and outcomes in critically ill children.Clinical kidney journal · 2026Article
- Adjunctive metolazone in critically ill children with moderate-to-severe acute kidney injury and furosemide-refractory fluid overload.Pediatric nephrology (Berlin, Germany) · 2026Article
- Cryptic and Overt Acute Kidney Injury Share Biomarker Characteristics in Pediatric Acute Respiratory Distress Syndrome.Critical care explorations · 2026Observational
- Putting the pieces together: solving the puzzle of early acute kidney injury post pediatric cardiac surgery.Pediatric research · 2026Article
- Pediatric sepsis-associated acute kidney injury: leveraging pathophysiology for risk stratification and identification of treatable traits.Pediatric nephrology (Berlin, Germany) · 2026Review
- Efficacy of the STARZ stratification score in determining the risk of acute kidney injury in critically ill neonates.Pediatric nephrology (Berlin, Germany) · 2026Article
- 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
- Neonatal AKI Definition: Is the perfect definition attainable or even desirable? Proceedings from the First International Neonatal Nephrology Symposium.Pediatric research · 2026Article
- Biomarkers in neonatal kidney disease: proceedings from the first international neonatal nephrology symposium.Pediatric research · 2026Article
- Urine neutrophil gelatinase-associated lipocalin predicts kidney support therapy duration and liberation in critically ill children.Pediatric research · 2026Article
- Predicting Continuous Kidney Support Therapy (CKST) time: the role of urine NGAL in guiding CKST duration and discontinuation.Pediatric research · 2026Article
- Extracorporeal membrane oxygenation, acute kidney injury, fluid balance, and continuous renal replacement therapy: Acute Disease Quality Initiative (ADQI) and Extracorporeal Life Support Organization (ELSO) joint consensus conference.Intensive care medicine · 2026Article
- Research progress on biomarkers for acute kidney injury in children.Pediatric nephrology (Berlin, Germany) · 2026Review
- Urine NGAL adds to serum creatinine in predicting cefepime clearance in critically ill children at high risk of acute kidney injury.International journal of antimicrobial agents · 2026Article
- A nomogram model for predicting acute kidney injury in critically ill patients with upper gastrointestinal bleeding: a study based on the MIMIC-IV database and external validation.BMC gastroenterology · 2026Article
- Serum renin levels refine acute kidney injury prediction in critically ill children.Pediatric nephrology (Berlin, Germany) · 2026Observational
- Refining AKI Diagnosis: Is There a Return on the Investment?Kidney international reports · 2026Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
Introduction: Critically ill admitted patients are at high risk of acute kidney injury (AKI). The renal angina index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT Use (TAKING FOCUS 2; TF2) to personalize fluid management and continuous renal replacement therapy (CRRT) initiation based on AKI risk and patient fluid accumulation. We compared outcomes pre-TF2 and post-TF2 initiation. Methods: Patients admitted from July 2017 were followed-up prospectively with the following: (i) an automated RAI result at 12 hours of admission, (ii) a conditional uNGAL order for RAI ≥8, and (iii) a CRRT initiation goal at 10% to 15% weight-based fluid accumulation. Results: A total of 286 patients comprised 304 intensive care unit (ICU) RAI+ admissions; 178 patients received CRRT over the observation period (2014-2021). Median time from ICU admission to CRRT initiation was 2 days shorter ( Conclusion: We suggest that automated clinical decision support (CDS) combining risk stratification and AKI biomarker assessment can produce durable reductions in pediatric CRRT patient morbidity.
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Registered trials
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.