Evidence map›Paper›PMID 42049965›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

Fluid accumulation and outcomes in children receiving continuous kidney replacement therapy: an appraisal of the WE-ROCK registry.

David T Selewski, Katja M Gist, Akash Deep, Lama Elbahlawan, Dana Y Fuhrman, Ben Gelbart, Stephen M Gorga, Kenneth E Mah, Nicholas J Ollberding, Stephanie Reynaud and 9 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

19 authors.

David T SelewskiDepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA. dselewski@uams.edu.ORCID http://orcid.org/0000-0003-0358-0760
Katja M GistDepartment of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Akash DeepPaediatric Intensive Care Unit, King's College Hospital, London, UK.
Lama ElbahlawanDivision of Critical Care, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA.
Dana Y FuhrmanDepartment of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Ben GelbartRoyal Children's Hospital, University of Melbourne, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Stephen M GorgaDepartment of Pediatrics, University of Michigan Medical School, C.S. Mott Children's Hospital, Ann Arbor, MI, USA.
Kenneth E MahDepartment of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Nicholas J OllberdingDivision of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Stephanie ReynaudDepartment of Pediatric Critical Care, Department of Critical Care, IWK Health, Dalhousie University, Halifax, NS, Canada.
Jangdong SeoDivision of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Danielle E SorannoDepartment of Pediatrics, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
Natalja L StanskiDivision of Critical Care Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Michelle C StarrDepartment of Pediatrics, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
Amanda M UberDepartment of Nephrology, Primary Children's Hospital, University of Utah, Salt Lake City, UT, USA.
David J AskenaziDepartment of Pediatrics, Division of Pediatric Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA.
Scott M SutherlandDepartment of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Shina MenonDepartment of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) Collaborative

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prospective pediatric Continuous Renal Replacement Therapy (ppCRRT) registry identified the degree of fluid accumulation (FA) at continuous kidney replacement therapy (CKRT) initiation as a predictor of adverse outcomes in children. These predate major advancements in CKRT technology and fluid stewardship. We aimed to describe the epidemiology of FA at CKRT initiation and associated outcomes in a contemporary paediatric cohort.

methodsSecondary analysis of Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK), a retrospective, multicenter study (35 centers, 9 countries) of patients ≤ 25 years treated with CKRT from 2015 to 2021. PRIMARY OUTCOME: survival to ICU discharge. SECONDARY OUTCOMES: ventilator-free and ICU-free days.

resultsA total of 1027 patients were included in this analysis. Survival to ICU discharge was 64.5% (n = 663). Median FA at CKRT initiation was 7.4% (IQR 2.4-18.1). FA differed between ICU survivors and non-survivors (7% [IQR 2-17] vs. 9% [IQR 3-21], p = 0.004). At CKRT initiation, 605 patients (58.9%) had FA < 10%, 194 patients (18.9%) had 10%-20% FA, and 228 patients (22.2%) had > 20% FA. In multivariable analysis, FA at CKRT initiation was not associated with ICU mortality but was associated with fewer ventilator (aOR 0.84, 95%CI 0.76-0.94, p = 0.023) and ICU-free days (aOR 0.6, 95%CI 0.49-0.73, p < 0.001).

conclusionsThe current study provides a contemporary evaluation of the epidemiology and impact of FA at CKRT initiation on outcomes in a cohort of > 1000 children treated with CKRT for FA/AKI. Clinically significant FA remains common at CKRT initiation and is associated with outcomes. This contemporary data can be used to inform clinical care and plan prospective studies.

Indexed as

Acute Kidney InjuryContinuous Renal Replacement TherapyWater-Electrolyte ImbalanceAdolescentAdultChildChild, PreschoolFemaleHumansInfantInfant, NewbornIntensive Care Units, PediatricMaleRegistriesRetrospective StudiesTreatment OutcomeAcute kidney injuryContinuous kidney replacement therapyDatabaseFluid overloadPediatricTechniqueWE-ROCK

Identifiers

PMID42049965

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.