ArticlePediatric nephrology (Berlin, Germany)2026
Development and validation of prediction models for any and severe acute kidney injury in children with sepsis.
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.
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Abstract
backgroundSepsis-associated acute kidney injury (SA-AKI) is a serious complication in children. We developed and validated models to predict any AKI and severe AKI in pediatric sepsis.
methodsThis retrospective study included 375 children who met the Phoenix sepsis criteria between January 2019 and December 2025. Patients who developed AKI during the first 24 h were excluded. Outcomes were any AKI (KDIGO stages 1-3) and severe AKI (stages 2-3) occurring from 24 h through day 7. Patients were randomly divided into training and validation cohorts (7:3). Predictors were selected using LASSO followed by multivariable logistic regression. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis.
resultsNew-onset AKI occurred in 111 patients (29.6%), including 90 (24.0%) with severe AKI. The any AKI model included age, mechanical ventilation, activated partial thromboplastin time, uric acid, and cystatin C. Its AUCs were 0.911 (95% CI, 0.874-0.948) and 0.911 (95% CI, 0.854-0.968) in the training and validation cohorts. The severe AKI model included lactate, activated partial thromboplastin time, blood urea nitrogen, and uric acid, with corresponding AUCs of 0.864 (95% CI, 0.809-0.919) and 0.897 (95% CI, 0.817-0.977). Both models showed acceptable calibration and positive net benefit. Sensitivity analyses using an alternative baseline serum creatinine definition yielded similar results.
conclusionsTwo models based on routinely available early variables showed good internal performance for predicting any AKI and severe AKI in pediatric sepsis. External validation is required before clinical implementation.
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