Dataset Information

A New Criterion for Pediatric AKI Based on the Reference Change Value of Serum Creatinine.

ABSTRACT:

Background

Current definitions of AKI do not take into account serum creatinine's high variability in children.

Methods

We analyzed data from 156,075 hospitalized children with at least two creatinine tests within 30 days. We estimated reference change value (RCV) of creatinine on the basis of age and initial creatinine level in children without kidney disease or known AKI risk, and we used these data to develop a model for detecting pediatric AKI on the basis of RCV of creatinine. We defined pediatric AKI according to pediatric reference change value optimized for AKI in children (pROCK) as creatinine increase beyond RCV of creatinine, which was estimated as the greater of 20 ?mol/L or 30% of the initial creatinine level.

Results

Of 102,817 children with at least two serum creatinine tests within 7 days, 5432 (5.3%) had AKI as defined by pROCK compared with 15,647 (15.2%) and 10,446 (10.2%) as defined by pediatric RIFLE (pRIFLE) and Kidney Disease Improving Global Outcomes (KDIGO), respectively. Children with pROCK-defined AKI had significantly increased risk of death (hazard ratio, 3.56; 95% confidence interval, 3.15 to 4.04) compared with those without AKI. About 66% of patients with pRIFLE-defined AKI and 51% of patients with KDIGO-defined AKI, mostly children with initial creatinine level of <30 ?mol/L, were reclassified as non-AKI by pROCK, and mortality risk in these children was comparable with risk in those without AKI by all definitions.

Conclusions

pROCK criterion improves detection of "true" AKI in children compared with earlier definitions that may lead to pediatric AKI overdiagnosis.

SUBMITTER: Xu X

PROVIDER: S-EPMC6115652 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

A New Criterion for Pediatric AKI Based on the Reference Change Value of Serum Creatinine.

Xu Xin X Nie Sheng S Zhang Aihua A Jianhua Mao M Liu Hai-Peng HP Xia Huimin H Xu Hong H Liu Zhangsuo Z Feng Shipin S Zhou Wei W Liu Xuemei X Yang Yonghong Y Tao Yuhong Y Feng Yunlin Y Chen Chunbo C Wang Mo M Zha Yan Y Feng Jian-Hua JH Li Qingchu Q Ge Shuwang S Chen Jianghua J He Yongcheng Y Teng Siyuan S Hao Chuanming C Liu Bi-Cheng BC Tang Ying Y Wang Li-Jun LJ Qi Jin-Lei JL He Wenjuan W He Pinghong P Liu Youhua Y Hou Fan Fan FF

Journal of the American Society of Nephrology : JASN 20180727 9

<h4>Background</h4>Current definitions of AKI do not take into account serum creatinine's high variability in children.<h4>Methods</h4>We analyzed data from 156,075 hospitalized children with at least two creatinine tests within 30 days. We estimated reference change value (RCV) of creatinine on the basis of age and initial creatinine level in children without kidney disease or known AKI risk, and we used these data to develop a model for detecting pediatric AKI on the basis of RCV of creatinine ...[more]

PMID: 30054338

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Dataset Information

A New Criterion for Pediatric AKI Based on the Reference Change Value of Serum Creatinine.

Background

Methods

Results

Conclusions

Publications

A New Criterion for Pediatric AKI Based on the Reference Change Value of Serum Creatinine.

Similar Datasets

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