Recalibration of the Renal Angina Index for Pediatric Septic Shock.
acute kidney injury
precision medicine
prediction
septic shock
Journal
Kidney international reports
ISSN: 2468-0249
Titre abrégé: Kidney Int Rep
Pays: United States
ID NLM: 101684752
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
22
03
2021
accepted:
16
04
2021
entrez:
26
7
2021
pubmed:
27
7
2021
medline:
27
7
2021
Statut:
epublish
Résumé
Sepsis-associated acute kidney injury (AKI) is a common diagnosis in children that is associated with poor outcomes. The lack of therapeutic options once present makes early identification of at-risk patients essential. The renal angina index (RAI) has been previously validated to predict severe AKI in heterogeneous populations of critically ill children. The performance of this score specifically in children with septic shock is unknown. A secondary analysis of a multicenter, prospective, observational study of 379 children with septic shock to determine the ability of the RAI to predict severe AKI at day 3, and to assess for the potential need for recalibration of the RAI in this unique subset of patients. At the original cutoff of ≥8, the RAI predicted day 3 severe AKI with an area under the receiving operating characteristic (AUROC) curve 0.90 (95% confidence interval [CI]: 0.86 to 93), 95% sensitivity, and 54% specificity. A Youden's index identified a higher optimal cutoff of ≥20 (sensitivity 83%, specificity 80%), and day 1 platelet count <150 × 10 The RAI appears to be a sensitive and reliable tool for prediction of severe AKI in children with septic shock, although the use of a recalibrated sepsis-specific RAI using a higher cutoff and platelet count may be beneficial.
Identifiants
pubmed: 34307980
doi: 10.1016/j.ekir.2021.04.022
pii: S2468-0249(21)01135-9
pmc: PMC8258591
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1858-1867Subventions
Organisme : NIDDK NIH HHS
ID : K23 DK119463
Pays : United States
Informations de copyright
© 2021 International Society of Nephrology. Published by Elsevier Inc.
Références
Crit Care Med. 2014 Feb;42(2):397-403
pubmed: 24145842
Kidney Int. 2014 Mar;85(3):659-67
pubmed: 24048379
Am J Respir Crit Care Med. 2015 May 15;191(10):1147-57
pubmed: 25734408
Physiol Genomics. 2007 Jul 18;30(2):146-55
pubmed: 17374846
Am J Respir Crit Care Med. 2020 Apr 1;201(7):848-855
pubmed: 31916857
Crit Care Med. 2016 Dec;44(12):2241-2250
pubmed: 27513354
Shock. 2015 Jan;43(1):68-73
pubmed: 25247784
N Engl J Med. 2018 Mar 1;378(9):829-839
pubmed: 29485925
Epidemiology. 2010 Jan;21(1):128-38
pubmed: 20010215
Ann Surg. 2018 Jun;267(6):1013-1020
pubmed: 28857811
JAMA. 2005 Aug 17;294(7):813-8
pubmed: 16106006
Ren Fail. 2014 Nov;36(10):1559-63
pubmed: 25154466
Sci Transl Med. 2019 Nov 13;11(518):
pubmed: 31723040
Crit Care. 2011;15(6):R273
pubmed: 22098946
Crit Care Clin. 2015 Oct;31(4):661-74
pubmed: 26410136
Intensive Care Med. 2009 May;35(5):871-81
pubmed: 19066848
Crit Care Med. 2001 Jul;29(7):1303-10
pubmed: 11445675
Pediatr Crit Care Med. 2020 Sep;21(9):e686-e695
pubmed: 32569242
Clin J Am Soc Nephrol. 2014 Apr;9(4):654-62
pubmed: 24677554
JAMA. 2016 Feb 23;315(8):801-10
pubmed: 26903338
Lancet Child Adolesc Health. 2018 Feb;2(2):112-120
pubmed: 30035208
N Engl J Med. 2017 Jan 5;376(1):11-20
pubmed: 27959707
Intensive Care Med. 2011 Jul;37(7):1166-73
pubmed: 21533569
Intensive Care Med. 2017 Nov;43(11):1551-1561
pubmed: 28110412
Crit Care Med. 1996 May;24(5):743-52
pubmed: 8706448
J Thorac Cardiovasc Surg. 2018 Jun;155(6):2441-2452.e13
pubmed: 29366580
Intensive Care Med. 2015 Aug;41(8):1411-23
pubmed: 26162677
Crit Care. 2017 Aug 25;21(1):229
pubmed: 28841902
Am J Respir Crit Care Med. 2003 Mar 1;167(5):695-701
pubmed: 12433670
Semin Nephrol. 2015 Jan;35(1):2-11
pubmed: 25795495
Nephrol Dial Transplant. 2016 Apr;31(4):586-94
pubmed: 26908772
J Crit Care. 2019 Oct;53:1-7
pubmed: 31174170
Kidney Int. 2019 Nov;96(5):1083-1099
pubmed: 31443997
Pediatr Nephrol. 2019 Oct;34(10):1777-1784
pubmed: 31286243
Clin J Am Soc Nephrol. 2008 Jul;3(4):948-54
pubmed: 18417742
Nat Rev Nephrol. 2018 Apr;14(4):217-230
pubmed: 29355173
Pediatr Crit Care Med. 2005 Jan;6(1):2-8
pubmed: 15636651
Intensive Care Med. 2020 May;46(5):1050-1051
pubmed: 32047942
Crit Care Med. 2016 Oct;44(10):1851-60
pubmed: 27355527
Crit Care Med. 2008 Apr;36(4):1297-303
pubmed: 18379258
Crit Care. 2012 Oct 01;16(5):R174
pubmed: 23025259
Clin J Am Soc Nephrol. 2015 Aug 7;10(8):1324-31
pubmed: 26195505