ArticlePediatric nephrology (Berlin, Germany)2026
Adjunctive metolazone in critically ill children with moderate-to-severe acute kidney injury and furosemide-refractory fluid overload.
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.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundData on metolazone in children with fluid overload and moderate-to-severe acute kidney injury (AKI) inadequately responsive to continuous furosemide infusion are limited. We describe its use and factors associated with kidney replacement therapy (KRT).
methodsThis retrospective cohort study in a pediatric intensive care unit included patients with KDIGO stage 2/3 AKI, continuous furosemide infusion, metolazone for inadequate urine output, and no chronic dialysis. Urine output was compared between the 6 h before metolazone and predefined 48-h intervals. Multivariable logistic regression and receiver operating characteristic (ROC) analysis evaluated associations with KRT.
resultsOf 196 metolazone-treated children, 62 met inclusion criteria. Median age was 40.5 months (IQR 11-144.5); 61% had stage 3 AKI, 90% were invasively ventilated, and median vasoactive-inotropic score was 10 (IQR 0-26). Median urine output increased from 0.8 mL/kg/h before metolazone to 1.49, 1.37, 2.5, and 2.68 mL/kg/h during 0-6, 6-12, 12-24, and 24-48 h, respectively (all p < 0.01). Children received a median of 3 doses over 48 h. Twenty children (32%) required KRT. Greater 12-24-h urine-output increase was associated with lower KRT odds (odds ratio 0.59, 95% CI 0.36-0.96; p = 0.034). AUC was 0.708 (95% CI 0.568-0.849; p = 0.010), with optimal cutoff ≥ 0.85 mL/kg/h; in 24-h landmark analysis, AUC was 0.683 (95% CI 0.527-0.838; p = 0.021), with the same cutoff.
conclusionsMetolazone initiation was followed by increased urine output. Response was associated with lower KRT likelihood. These exploratory findings require prospective validation.
Indexed as
Identifiers
42717003What OpenQuestion holds
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.