Evidence map›Paper›PMID 38740594›Full record

Observational studyPediatric nephrology (Berlin, Germany)2024

Renal resistive index by point of care ultrasound to predict sepsis associated acute kidney injury in critically ill children.

Muthuvel Rajangam, Karthi Nallasamy, Anmol Bhatia, Vinod Kumar, Prabhjot Kaur, Suresh Kumar Angurana

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Pediatric nephrology (Berlin, Germany), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Research progress on biomarkers for acute kidney injury in children.Pediatric nephrology (Berlin, Germany) · 2026
    Review
  3. Article
  4. Review
  5. Review
  6. Kidney point-of-care ultrasonography in the PICU: it is about time!Pediatric nephrology (Berlin, Germany) · 2024
    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

6 authors.

Muthuvel RajangamPediatric Critical Care Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Karthi NallasamyPediatric Critical Care Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. ny.karthi@gmail.com.ORCID 0000-0002-6713-9846
Anmol BhatiaDepartment of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Vinod KumarDepartment of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Prabhjot KaurDepartment of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Suresh Kumar AnguranaPediatric Critical Care Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Funding

Indian Council of Medical Research No.3/2/Dec-2021/PG-Thesis-HRD (31)
6 · The paper itself

Abstract

backgroundSepsis associated acute kidney injury (AKI) is linked with adverse outcomes in the PICU. Doppler-based renal resistive index (RRI) has shown promising results in adults for prediction of AKI. We aimed to explore the performance of RRI in children with sepsis.

methodsThis prospective observational study (March - November 2022) included children aged 1-12 years with sepsis admitted to the PICU. RRI and urine neutrophil gelatinase associated lipocalin (NGAL) were measured within 12 h of admission. Children were followed up for 3 days. AKI (new and persistent) was defined as any child with KDIGO stage 2 or 3 AKI on day 3.

resultsWe enrolled 90 children but included 79 in final analysis. Two thirds (n = 53, 67%) had septic shock. Median (IQR) age was 6.2 years (4.1-9.2). RRI decreased with increasing age. Twenty-six (33%) children had AKI on day 3. Mean (SD) RRI was higher in the AKI group [0.72 (0.08) vs. 0.65 (0.07), p < 0.001].The area under ROC curve for RRI to detect AKI among the 1-4 year old group was 0.75 (95% CI:0.51, 0.98; p = 0.05) and among the 5-12 year old group was 0.76 (0.62, 0.89; p = 0.001). An RRI 0.71 predicted AKI with 100% sensitivity and 46.2% specificity among the 1-4-year-old group and RRI 0.69 predicted it with 70% sensitivity and 77.5% specificity in the 5-12-year-old group. RRI and eGFR at admission were independent predictors of AKI on multivariable analysis. Urine NGAL 94.8 ng/ml predicted AKI with 76.9% sensitivity and 77.4% specificity and AUROC was 0.74 (0.62, 0.86) among the 1-12-year-old group.

conclusionsRRI values varied with age. RRI showed good diagnostic accuracy to detect new/persistent AKI on day 3 in children with sepsis; however, it was less precise as an independent predictor.

Indexed as

Acute Kidney InjuryCritical IllnessLipocalin-2SepsisBiomarkersChildChild, PreschoolFemaleHumansInfantIntensive Care Units, PediatricKidneyMalePoint-of-Care SystemsPredictive Value of TestsProspective StudiesBiomarkersLCN2 protein, humanLipocalin-2Acute kidney injuryNGALPICUPoint of care ultrasoundRenal resistive indexSepsis

Identifiers

PMID38740594

What OpenQuestion holds

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Registered trials

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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.