Real-Time Acute Kidney Injury Risk Stratification – Biomarker Directed Fluid Management Improves Outcomes in Critically Ill Children and Young Adults
Critically ill admitted are at high risk of acute kidney injury (AKI). The Renal Angina Index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT USe, (TAKING FOC...
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| Vydáno v: | Kidney international reports Ročník 8; číslo 12; s. 2690 - 2700 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
Elsevier Inc
01.12.2023
Elsevier |
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| ISSN: | 2468-0249, 2468-0249 |
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| Abstract | Critically ill admitted are at high risk of acute kidney injury (AKI). The Renal Angina Index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT USe, (TAKING FOCUS 2; TF2) to personalize fluid management and CRRT initiation based on AKI risk and patient fluid accumulation. We compared outcomes pre- and post-TF2 initiation.
Patients admitted from 07/2017 were followed prospectively with: (1) automated RAI result at 12 hours of admission, (2) conditional uNGAL order for RAI>8 and (3) a CRRT initiation goal at 10-15% weight-based fluid accumulation.
286 patients comprised 304 ICU RAI+ admissions; 178 received CRRT over the observation period (2014-2021). Median time from ICU admission to CRRT initiation was 2 days shorter (p<0.002), and >15% pre-CRRT fluid accumulation rate was lower in the TF2 era (p<0.02). TF2 ICU length of stay after CRRT discontinuation and total ICU length of stay were six and 11 days shorter for CRRT survivors (both p<0.02). Survival rates to ICU discharge after CRRT discontinuation were higher in the TF2 era (p=0.001). These associations persisted in each TF2 year; we estimate a conservative $12,500 healthcare cost savings per CRRT patient treated after TF2 implementation.
We suggest automated clinical decision support combining risk stratification and AKI biomarker assessment can produce durable reductions in pediatric CRRT patient morbidity. |
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| AbstractList | Critically ill admitted are at high risk of acute kidney injury (AKI). The Renal Angina Index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT USe, (TAKING FOCUS 2; TF2) to personalize fluid management and CRRT initiation based on AKI risk and patient fluid accumulation. We compared outcomes pre- and post-TF2 initiation.
Patients admitted from 07/2017 were followed prospectively with: (1) automated RAI result at 12 hours of admission, (2) conditional uNGAL order for RAI>8 and (3) a CRRT initiation goal at 10-15% weight-based fluid accumulation.
286 patients comprised 304 ICU RAI+ admissions; 178 received CRRT over the observation period (2014-2021). Median time from ICU admission to CRRT initiation was 2 days shorter (p<0.002), and >15% pre-CRRT fluid accumulation rate was lower in the TF2 era (p<0.02). TF2 ICU length of stay after CRRT discontinuation and total ICU length of stay were six and 11 days shorter for CRRT survivors (both p<0.02). Survival rates to ICU discharge after CRRT discontinuation were higher in the TF2 era (p=0.001). These associations persisted in each TF2 year; we estimate a conservative $12,500 healthcare cost savings per CRRT patient treated after TF2 implementation.
We suggest automated clinical decision support combining risk stratification and AKI biomarker assessment can produce durable reductions in pediatric CRRT patient morbidity. Critically ill admitted patients are at high risk of acute kidney injury (AKI). The renal angina index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT Use (TAKING FOCUS 2; TF2) to personalize fluid management and continuous renal replacement therapy (CRRT) initiation based on AKI risk and patient fluid accumulation. We compared outcomes pre-TF2 and post-TF2 initiation. Patients admitted from July 2017 were followed-up prospectively with the following: (i) an automated RAI result at 12 hours of admission, (ii) a conditional uNGAL order for RAI ≥8, and (iii) a CRRT initiation goal at 10% to 15% weight-based fluid accumulation. A total of 286 patients comprised 304 intensive care unit (ICU) RAI+ admissions; 178 patients received CRRT over the observation period (2014-2021). Median time from ICU admission to CRRT initiation was 2 days shorter ( < 0.002), and ≥15% pre-CRRT fluid accumulation rate was lower in the TF2 era ( < 0.02). TF2 ICU length of stay (LOS) after CRRT discontinuation and total ICU LOS were 6 and 11 days shorter for CRRT survivors (both < 0.02). Survival rates to ICU discharge after CRRT discontinuation were higher in the TF2 era ( = 0.001). These associations persisted in each TF2 year; we estimate a conservative $12,500 health care cost savings per CRRT patient treated after TF2 implementation. We suggest that automated clinical decision support (CDS) combining risk stratification and AKI biomarker assessment can produce durable reductions in pediatric CRRT patient morbidity. Critically ill admitted patients are at high risk of acute kidney injury (AKI). The renal angina index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT Use (TAKING FOCUS 2; TF2) to personalize fluid management and continuous renal replacement therapy (CRRT) initiation based on AKI risk and patient fluid accumulation. We compared outcomes pre-TF2 and post-TF2 initiation.IntroductionCritically ill admitted patients are at high risk of acute kidney injury (AKI). The renal angina index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT Use (TAKING FOCUS 2; TF2) to personalize fluid management and continuous renal replacement therapy (CRRT) initiation based on AKI risk and patient fluid accumulation. We compared outcomes pre-TF2 and post-TF2 initiation.Patients admitted from July 2017 were followed-up prospectively with the following: (i) an automated RAI result at 12 hours of admission, (ii) a conditional uNGAL order for RAI ≥8, and (iii) a CRRT initiation goal at 10% to 15% weight-based fluid accumulation.MethodsPatients admitted from July 2017 were followed-up prospectively with the following: (i) an automated RAI result at 12 hours of admission, (ii) a conditional uNGAL order for RAI ≥8, and (iii) a CRRT initiation goal at 10% to 15% weight-based fluid accumulation.A total of 286 patients comprised 304 intensive care unit (ICU) RAI+ admissions; 178 patients received CRRT over the observation period (2014-2021). Median time from ICU admission to CRRT initiation was 2 days shorter (P < 0.002), and ≥15% pre-CRRT fluid accumulation rate was lower in the TF2 era (P < 0.02). TF2 ICU length of stay (LOS) after CRRT discontinuation and total ICU LOS were 6 and 11 days shorter for CRRT survivors (both P < 0.02). Survival rates to ICU discharge after CRRT discontinuation were higher in the TF2 era (P = 0.001). These associations persisted in each TF2 year; we estimate a conservative $12,500 health care cost savings per CRRT patient treated after TF2 implementation.ResultsA total of 286 patients comprised 304 intensive care unit (ICU) RAI+ admissions; 178 patients received CRRT over the observation period (2014-2021). Median time from ICU admission to CRRT initiation was 2 days shorter (P < 0.002), and ≥15% pre-CRRT fluid accumulation rate was lower in the TF2 era (P < 0.02). TF2 ICU length of stay (LOS) after CRRT discontinuation and total ICU LOS were 6 and 11 days shorter for CRRT survivors (both P < 0.02). Survival rates to ICU discharge after CRRT discontinuation were higher in the TF2 era (P = 0.001). These associations persisted in each TF2 year; we estimate a conservative $12,500 health care cost savings per CRRT patient treated after TF2 implementation.We suggest that automated clinical decision support (CDS) combining risk stratification and AKI biomarker assessment can produce durable reductions in pediatric CRRT patient morbidity.ConclusionWe suggest that automated clinical decision support (CDS) combining risk stratification and AKI biomarker assessment can produce durable reductions in pediatric CRRT patient morbidity. Introduction: Critically ill admitted patients are at high risk of acute kidney injury (AKI). The renal angina index (RAI) and urinary biomarker neutrophil gelatinase-associated lipocalin (uNGAL) can aid in AKI risk assessment. We implemented the Trial in AKI using NGAL and Fluid Overload to optimize CRRT Use (TAKING FOCUS 2; TF2) to personalize fluid management and continuous renal replacement therapy (CRRT) initiation based on AKI risk and patient fluid accumulation. We compared outcomes pre-TF2 and post-TF2 initiation. Methods: Patients admitted from July 2017 were followed-up prospectively with the following: (i) an automated RAI result at 12 hours of admission, (ii) a conditional uNGAL order for RAI ≥8, and (iii) a CRRT initiation goal at 10% to 15% weight-based fluid accumulation. Results: A total of 286 patients comprised 304 intensive care unit (ICU) RAI+ admissions; 178 patients received CRRT over the observation period (2014–2021). Median time from ICU admission to CRRT initiation was 2 days shorter (P < 0.002), and ≥15% pre-CRRT fluid accumulation rate was lower in the TF2 era (P < 0.02). TF2 ICU length of stay (LOS) after CRRT discontinuation and total ICU LOS were 6 and 11 days shorter for CRRT survivors (both P < 0.02). Survival rates to ICU discharge after CRRT discontinuation were higher in the TF2 era (P = 0.001). These associations persisted in each TF2 year; we estimate a conservative $12,500 health care cost savings per CRRT patient treated after TF2 implementation. Conclusion: We suggest that automated clinical decision support (CDS) combining risk stratification and AKI biomarker assessment can produce durable reductions in pediatric CRRT patient morbidity. |
| Author | Roy, Jean-Philippe Collins, Michaela Fei, Lin Goldstein, Stuart L. Chawla, Lakhmir Krallman, Kelli A. Basu, Rajit K. Chima, Ranjit S. |
| Author_xml | – sequence: 1 givenname: Stuart L. surname: Goldstein fullname: Goldstein, Stuart L. email: stuart.goldstein@cchmc.org organization: Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA – sequence: 2 givenname: Kelli A. surname: Krallman fullname: Krallman, Kelli A. organization: Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA – sequence: 3 givenname: Jean-Philippe surname: Roy fullname: Roy, Jean-Philippe organization: Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA – sequence: 4 givenname: Michaela surname: Collins fullname: Collins, Michaela organization: Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA – sequence: 5 givenname: Ranjit S. surname: Chima fullname: Chima, Ranjit S. organization: Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA – sequence: 6 givenname: Rajit K. surname: Basu fullname: Basu, Rajit K. organization: Lurie Children’s Hospital, Chicago Illinois, USA – sequence: 7 givenname: Lakhmir surname: Chawla fullname: Chawla, Lakhmir organization: Department of Veteran’s Affairs, Washington, DC, USA – sequence: 8 givenname: Lin surname: Fei fullname: Fei, Lin organization: Department of Veteran’s Affairs, Washington, DC, USA |
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| Cites_doi | 10.1681/ASN.2008030287 10.1097/00003246-199605000-00004 10.1681/ASN.2018090886 10.2215/CJN.01900214 10.1007/s00467-021-05368-2 10.1186/s12969-017-0202-0 10.1001/jamanetworkopen.2022.29442 10.1186/s13054-021-03725-z 10.1038/ki.2013.349 10.1093/ndt/gfv457 10.2215/CJN.03200906 10.1097/PCC.0000000000000461 10.14814/phy2.15453 10.1177/21501351211073615 10.1001/jama.2016.5828 10.1186/s12882-021-02540-6 10.1016/j.ekir.2022.05.021 10.1007/s00467-019-04294-8 10.1186/cc6089 10.1016/S2352-4642(17)30181-5 10.1053/j.ajkd.2009.10.048 10.1097/CCM.0b013e3181cd12e1 10.1056/NEJMoa1603017 10.2215/CJN.05431207 10.1681/ASN.2017070765 10.1053/j.ajkd.2009.07.020 10.1001/jamapediatrics.2017.4540 10.1016/j.jacc.2010.11.051 10.1016/j.ekir.2021.04.022 10.1542/peds.107.6.1309 10.1056/NEJMoa1611391 10.1056/NEJMoa1803213 10.1016/j.jacc.2011.08.017 |
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| Keywords | renal angina index neutrophil gelatinase associated lipocalin children continuous renal replacement therapy Acute kidney injury acute kidney injury |
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| References | Symons, Chua, Somers (bib29) 2007; 2 Haase, Bellomo, Devarajan (bib25) 2009; 54 Campbell (bib34) 2013; 84 Schwartz, Munoz, Schneider (bib21) 2009; 20 Schneider, Khemani, Grushkin (bib5) 2010; 38 Stanski, Wong, Basu (bib37) 2021; 6 Basu, Zappitelli, Brunner (bib6) 2014; 85 Menon, Goldstein, Mottes (bib7) 2016; 31 Gorga, Carlton, Kohne (bib18) 2021; 22 Gist, SooHoo, Mack (bib38) 2022; 13 Sutherland, Zappitelli, Alexander (bib24) 2010; 55 Selby, Casula, Lamming (bib33) 2019; 30 Zappitelli, Washburn, Arikan (bib27) 2007; 11 Pollack, Patel, Ruttimann (bib30) 1996; 24 Krawczeski, Goldstein, Woo (bib28) 2011; 58 Al-Jaghbeer, Dealmeida, Bilderback (bib32) 2018; 29 Flannery, Ortiz-Soriano, Li (bib35) 2021; 25 Suppl 1: 1-138. Kaddourah, Basu, Bagshaw (bib4) 2017; 376 Abbasi, Mehdipour Rabori, Farajollahi (bib9) 2020; 8 Goldstein, Akcan-Arikan, Alobaidi (bib12) 2022; 5 Zarbock, Kellum, Schmidt (bib15) 2016; 315 Roy, Johnson, Towne (bib22) 2019; 34 Sutherland, Byrnes, Kothari (bib3) 2015; 10 Bennett, Ma, Ying (bib31) 2017; 15 Goldstein, Krallman, Kirby (bib10) 2022; 7 Basu, Kaddourah, Goldstein (bib8) 2018; 2 Hasson, Krallman, VanDenHeuvel (bib36) 2022; 10 Alobaidi, Morgan, Basu (bib17) 2018; 172 Roy, Krallman, Basu (bib19) 2020 Goldstein, Currier, Graf (bib23) 2001; 107 Haase, Devarajan, Haase-Fielitz (bib26) 2011; 57 Gaudry, Hajage, Schortgen (bib14) 2016; 375 KDIGO clinical practice guideline for acute kidney injury. Kidney Interational 2012; 2 Meena, Kumar, Thomas (bib11) 2022; 37 Investigators (bib13) 2020; 383 Sanchez-Pinto, Goldstein, Schneider (bib2) 2015; 16 Barbar, Clere-Jehl, Bourredjem (bib16) 2018; 379 Zappitelli, Parikh, Akcan-Arikan (bib20) 2008; 3 Basu (10.1016/j.ekir.2023.09.019_bib8) 2018; 2 Bennett (10.1016/j.ekir.2023.09.019_bib31) 2017; 15 Campbell (10.1016/j.ekir.2023.09.019_bib34) 2013; 84 Barbar (10.1016/j.ekir.2023.09.019_bib16) 2018; 379 Stanski (10.1016/j.ekir.2023.09.019_bib37) 2021; 6 Kaddourah (10.1016/j.ekir.2023.09.019_bib4) 2017; 376 Symons (10.1016/j.ekir.2023.09.019_bib29) 2007; 2 Meena (10.1016/j.ekir.2023.09.019_bib11) 2022; 37 Investigators (10.1016/j.ekir.2023.09.019_bib13) 2020; 383 Schwartz (10.1016/j.ekir.2023.09.019_bib21) 2009; 20 Roy (10.1016/j.ekir.2023.09.019_bib22) 2019; 34 Zappitelli (10.1016/j.ekir.2023.09.019_bib27) 2007; 11 Roy (10.1016/j.ekir.2023.09.019_bib19) 2020; 10 Schneider (10.1016/j.ekir.2023.09.019_bib5) 2010; 38 Menon (10.1016/j.ekir.2023.09.019_bib7) 2016; 31 Selby (10.1016/j.ekir.2023.09.019_bib33) 2019; 30 Haase (10.1016/j.ekir.2023.09.019_bib25) 2009; 54 Al-Jaghbeer (10.1016/j.ekir.2023.09.019_bib32) 2018; 29 Goldstein (10.1016/j.ekir.2023.09.019_bib10) 2022; 7 Abbasi (10.1016/j.ekir.2023.09.019_bib9) 2020; 8 Gorga (10.1016/j.ekir.2023.09.019_bib18) 2021; 22 Goldstein (10.1016/j.ekir.2023.09.019_bib23) 2001; 107 Sutherland (10.1016/j.ekir.2023.09.019_bib24) 2010; 55 Haase (10.1016/j.ekir.2023.09.019_bib26) 2011; 57 Krawczeski (10.1016/j.ekir.2023.09.019_bib28) 2011; 58 Flannery (10.1016/j.ekir.2023.09.019_bib35) 2021; 25 Goldstein (10.1016/j.ekir.2023.09.019_bib12) 2022; 5 (10.1016/j.ekir.2023.09.019_bib1) 2012; 2 Basu (10.1016/j.ekir.2023.09.019_bib6) 2014; 85 Gaudry (10.1016/j.ekir.2023.09.019_bib14) 2016; 375 Sutherland (10.1016/j.ekir.2023.09.019_bib3) 2015; 10 Gist (10.1016/j.ekir.2023.09.019_bib38) 2022; 13 Alobaidi (10.1016/j.ekir.2023.09.019_bib17) 2018; 172 Zappitelli (10.1016/j.ekir.2023.09.019_bib20) 2008; 3 Zarbock (10.1016/j.ekir.2023.09.019_bib15) 2016; 315 Pollack (10.1016/j.ekir.2023.09.019_bib30) 1996; 24 Sanchez-Pinto (10.1016/j.ekir.2023.09.019_bib2) 2015; 16 Hasson (10.1016/j.ekir.2023.09.019_bib36) 2022; 10 |
| References_xml | – volume: 25 start-page: 294 year: 2021 ident: bib35 article-title: Serum renin and major adverse kidney events in critically ill patients: a multicenter prospective study publication-title: Crit Care – volume: 13 start-page: 196 year: 2022 end-page: 202 ident: bib38 article-title: Modifying the Renal Angina Index for Predicting AKI and Related Adverse Outcomes in Pediatric Heart Surgery publication-title: World J Pediatr Congenit Heart Surg – start-page: 10 year: 2020 ident: bib19 article-title: Early Sequential Risk Stratification Assessment to Optimize Fluid Dosing, CRRT Initiation and Discontinuation in Critically Ill Children with Acute Kidney Injury: Taking Focus 2 Process Article publication-title: J Clin Trials – volume: 107 start-page: 1309 year: 2001 end-page: 1312 ident: bib23 article-title: Outcome in children receiving continuous venovenous hemofiltration publication-title: Pediatrics – volume: 6 start-page: 1858 year: 2021 end-page: 1867 ident: bib37 article-title: Recalibration of the Renal Angina Index for Pediatric Septic Shock publication-title: Kidney Int Rep – volume: 375 start-page: 122 year: 2016 end-page: 133 ident: bib14 article-title: Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit publication-title: N Engl J Med – volume: 11 start-page: R84 year: 2007 ident: bib27 article-title: Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study publication-title: Crit Care – volume: 2 start-page: 112 year: 2018 end-page: 120 ident: bib8 article-title: Assessment of a renal angina index for prediction of severe acute kidney injury in critically ill children: a multicentre, multinational, prospective observational study publication-title: Lancet Child Adolesc Health – volume: 58 start-page: 2301 year: 2011 end-page: 2309 ident: bib28 article-title: Temporal relationship and predictive value of urinary acute kidney injury biomarkers after pediatric cardiopulmonary bypass publication-title: J Am Coll Cardiol – volume: 5 year: 2022 ident: bib12 article-title: Consensus-Based Recommendations on Priority Activities to Address Acute Kidney Injury in Children: A Modified Delphi Consensus Statement publication-title: JAMA Netw Open – volume: 315 start-page: 2190 year: 2016 end-page: 2199 ident: bib15 article-title: Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury: The ELAIN Randomized Clinical Trial publication-title: JAMA – volume: 84 start-page: 42 year: 2013 end-page: 47 ident: bib34 article-title: The five "rights" of clinical decision support publication-title: J AHIMA – volume: 3 start-page: 948 year: 2008 end-page: 954 ident: bib20 article-title: Ascertainment and epidemiology of acute kidney injury varies with definition interpretation publication-title: Clin J Am Soc Nephrol – reference: Suppl 1: 1-138. – volume: 85 start-page: 659 year: 2014 end-page: 667 ident: bib6 article-title: Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children publication-title: Kidney Int – reference: KDIGO clinical practice guideline for acute kidney injury. Kidney Interational 2012; 2 – volume: 7 start-page: 1842 year: 2022 end-page: 1849 ident: bib10 article-title: Integration of the Renal Angina Index and Urine Neutrophil Gelatinase-Associated Lipocalin Improves Severe Acute Kidney Injury Prediction in Critically Ill Children and Young Adults publication-title: Kidney Int Rep – volume: 2 start-page: 732 year: 2007 end-page: 738 ident: bib29 article-title: Demographic characteristics of pediatric continuous renal replacement therapy: a report of the prospective pediatric continuous renal replacement therapy registry publication-title: Clin J Am Soc Nephrol – volume: 15 start-page: 74 year: 2017 ident: bib31 article-title: Effects of age and gender on reference levels of biomarkers comprising the pediatric Renal Activity Index for Lupus Nephritis (p-RAIL) publication-title: Pediatr Rheumatol Online J – volume: 29 start-page: 654 year: 2018 end-page: 660 ident: bib32 article-title: Clinical Decision Support for In-Hospital AKI publication-title: J Am Soc Nephrol – volume: 10 year: 2022 ident: bib36 article-title: Olfactomedin 4 as a novel loop of Henle-specific acute kidney injury biomarker publication-title: Physiol Rep – volume: 57 start-page: 1752 year: 2011 end-page: 1761 ident: bib26 article-title: The outcome of neutrophil gelatinase-associated lipocalin-positive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies publication-title: J Am Coll Cardiol – volume: 10 start-page: 554 year: 2015 end-page: 561 ident: bib3 article-title: AKI in hospitalized children: comparing the pRIFLE, AKIN, and KDIGO definitions publication-title: Clin J Am Soc Nephrol – volume: 376 start-page: 11 year: 2017 end-page: 20 ident: bib4 article-title: Epidemiology of Acute Kidney Injury in Critically Ill Children and Young Adults publication-title: N Engl J Med – volume: 38 start-page: 933 year: 2010 end-page: 939 ident: bib5 article-title: Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in the pediatric intensive care unit publication-title: Crit Care Med – volume: 31 start-page: 586 year: 2016 end-page: 594 ident: bib7 article-title: Urinary biomarker incorporation into the renal angina index early in intensive care unit admission optimizes acute kidney injury prediction in critically ill children: a prospective cohort study publication-title: Nephrol Dial Transplant – volume: 172 start-page: 257 year: 2018 end-page: 268 ident: bib17 article-title: Association Between Fluid Balance and Outcomes in Critically Ill Children: A Systematic Review and Meta-analysis publication-title: JAMA Pediatr – volume: 34 start-page: 1777 year: 2019 end-page: 1784 ident: bib22 article-title: Use of height-independent baseline creatinine imputation method with renal angina index publication-title: Pediatr Nephrol – volume: 54 start-page: 1012 year: 2009 end-page: 1024 ident: bib25 article-title: Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis publication-title: Am J Kidney Dis – volume: 20 start-page: 629 year: 2009 end-page: 637 ident: bib21 article-title: New equations to estimate GFR in children with CKD publication-title: J Am Soc Nephrol – volume: 379 start-page: 1431 year: 2018 end-page: 1442 ident: bib16 article-title: Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis publication-title: N Engl J Med – volume: 22 start-page: 336 year: 2021 ident: bib18 article-title: Renal angina index predicts fluid overload in critically ill children: an observational cohort study publication-title: BMC Nephrol – volume: 24 start-page: 743 year: 1996 end-page: 752 ident: bib30 article-title: PRISM III: an updated Pediatric Risk of Mortality score publication-title: Crit Care Med – volume: 55 start-page: 316 year: 2010 end-page: 325 ident: bib24 article-title: Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry publication-title: Am J Kidney Dis – volume: 30 start-page: 505 year: 2019 end-page: 515 ident: bib33 article-title: An Organizational-Level Program of Intervention for AKI: A Pragmatic Stepped Wedge Cluster Randomized Trial publication-title: J Am Soc Nephrol – volume: 16 start-page: 703 year: 2015 end-page: 710 ident: bib2 article-title: Association Between Progression and Improvement of Acute Kidney Injury and Mortality in Critically Ill Children publication-title: Pediatr Crit Care Med – volume: 37 start-page: 1263 year: 2022 end-page: 1275 ident: bib11 article-title: Diagnostic accuracy of renal angina index alone or in combination with biomarkers for predicting acute kidney injury in children publication-title: Pediatr Nephrol – volume: 383 start-page: 240 year: 2020 end-page: 251 ident: bib13 article-title: Canadian Critical Care Trials G, Australian publication-title: N Engl J Med – volume: 8 start-page: e39 year: 2020 ident: bib9 article-title: Discriminatory Precision of Renal Angina Index in Predicting Acute Kidney Injury in Children; a Systematic Review and Meta-Analysis publication-title: Arch Acad Emerg Med – volume: 20 start-page: 629 year: 2009 ident: 10.1016/j.ekir.2023.09.019_bib21 article-title: New equations to estimate GFR in children with CKD publication-title: J Am Soc Nephrol doi: 10.1681/ASN.2008030287 – volume: 24 start-page: 743 year: 1996 ident: 10.1016/j.ekir.2023.09.019_bib30 article-title: PRISM III: an updated Pediatric Risk of Mortality score publication-title: Crit Care Med doi: 10.1097/00003246-199605000-00004 – volume: 30 start-page: 505 year: 2019 ident: 10.1016/j.ekir.2023.09.019_bib33 article-title: An organizational-level program of intervention for AKI: a pragmatic stepped wedge cluster randomized trial publication-title: J Am Soc Nephrol doi: 10.1681/ASN.2018090886 – volume: 10 start-page: 554 year: 2015 ident: 10.1016/j.ekir.2023.09.019_bib3 article-title: AKI in hospitalized children: comparing the pRIFLE, AKIN, and KDIGO definitions publication-title: Clin J Am Soc Nephrol doi: 10.2215/CJN.01900214 – volume: 37 start-page: 1263 year: 2022 ident: 10.1016/j.ekir.2023.09.019_bib11 article-title: Diagnostic accuracy of renal angina index alone or in combination with biomarkers for predicting acute kidney injury in children publication-title: Pediatr Nephrol doi: 10.1007/s00467-021-05368-2 – volume: 15 start-page: 74 year: 2017 ident: 10.1016/j.ekir.2023.09.019_bib31 article-title: Effects of age and gender on reference levels of biomarkers comprising the pediatric Renal Activity Index for lupus Nephritis (p-RAIL) publication-title: Pediatr Rheumatol Online J doi: 10.1186/s12969-017-0202-0 – volume: 5 year: 2022 ident: 10.1016/j.ekir.2023.09.019_bib12 article-title: Consensus-based recommendations on priority activities to address acute kidney injury in children: a modified Delphi consensus statement publication-title: JAMA Netw Open doi: 10.1001/jamanetworkopen.2022.29442 – volume: 25 start-page: 294 year: 2021 ident: 10.1016/j.ekir.2023.09.019_bib35 article-title: Serum renin and major adverse kidney events in critically ill patients: a multicenter prospective study publication-title: Crit Care doi: 10.1186/s13054-021-03725-z – volume: 85 start-page: 659 year: 2014 ident: 10.1016/j.ekir.2023.09.019_bib6 article-title: Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children publication-title: Kidney Int doi: 10.1038/ki.2013.349 – volume: 10 start-page: 435 year: 2020 ident: 10.1016/j.ekir.2023.09.019_bib19 article-title: Early sequential risk stratification assessment to optimize fluid dosing, CRRT initiation and discontinuation in critically ill children with acute kidney injury: taking focus 2 process article publication-title: J Clin Trials – volume: 31 start-page: 586 year: 2016 ident: 10.1016/j.ekir.2023.09.019_bib7 article-title: Urinary biomarker incorporation into the renal angina index early in intensive care unit admission optimizes acute kidney injury prediction in critically ill children: a prospective cohort study publication-title: Nephrol Dial Transplant doi: 10.1093/ndt/gfv457 – volume: 2 start-page: 732 year: 2007 ident: 10.1016/j.ekir.2023.09.019_bib29 article-title: Demographic characteristics of pediatric continuous renal replacement therapy: a report of the prospective pediatric continuous renal replacement therapy registry publication-title: Clin J Am Soc Nephrol doi: 10.2215/CJN.03200906 – volume: 16 start-page: 703 year: 2015 ident: 10.1016/j.ekir.2023.09.019_bib2 article-title: Association between progression and improvement of acute kidney injury and mortality in critically ill children publication-title: Pediatr Crit Care Med doi: 10.1097/PCC.0000000000000461 – volume: 10 year: 2022 ident: 10.1016/j.ekir.2023.09.019_bib36 article-title: Olfactomedin 4 as a novel loop of Henle-specific acute kidney injury biomarker publication-title: Physiol Rep doi: 10.14814/phy2.15453 – volume: 13 start-page: 196 year: 2022 ident: 10.1016/j.ekir.2023.09.019_bib38 article-title: Modifying the renal angina index for predicting AKI and related adverse outcomes in pediatric heart surgery publication-title: World J Pediatr Congenit Heart Surg doi: 10.1177/21501351211073615 – volume: 315 start-page: 2190 year: 2016 ident: 10.1016/j.ekir.2023.09.019_bib15 article-title: Effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN randomized clinical Trial publication-title: JAMA doi: 10.1001/jama.2016.5828 – volume: 22 start-page: 336 year: 2021 ident: 10.1016/j.ekir.2023.09.019_bib18 article-title: Renal angina index predicts fluid overload in critically ill children: an observational cohort study publication-title: BMC Nephrol doi: 10.1186/s12882-021-02540-6 – volume: 8 start-page: e39 year: 2020 ident: 10.1016/j.ekir.2023.09.019_bib9 article-title: Discriminatory precision of renal angina index in predicting acute kidney injury in children; a systematic review and meta-analysis publication-title: Arch Acad Emerg Med – volume: 7 start-page: 1842 year: 2022 ident: 10.1016/j.ekir.2023.09.019_bib10 article-title: Integration of the renal angina index and urine neutrophil gelatinase-associated lipocalin improves severe acute kidney injury prediction in critically ill children and young adults publication-title: Kidney Int Rep doi: 10.1016/j.ekir.2022.05.021 – volume: 34 start-page: 1777 year: 2019 ident: 10.1016/j.ekir.2023.09.019_bib22 article-title: Use of height-independent baseline creatinine imputation method with renal angina index publication-title: Pediatr Nephrol doi: 10.1007/s00467-019-04294-8 – volume: 11 start-page: R84 year: 2007 ident: 10.1016/j.ekir.2023.09.019_bib27 article-title: Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study publication-title: Crit Care doi: 10.1186/cc6089 – volume: 2 start-page: 1 issue: suppl 1 year: 2012 ident: 10.1016/j.ekir.2023.09.019_bib1 article-title: KDIGO clinical practice guideline for acute kidney injury publication-title: Kidney Interational – volume: 2 start-page: 112 year: 2018 ident: 10.1016/j.ekir.2023.09.019_bib8 article-title: Assessment of a renal angina index for prediction of severe acute kidney injury in critically ill children: a multicentre, multinational, prospective observational study publication-title: Lancet Child Adolesc Health doi: 10.1016/S2352-4642(17)30181-5 – volume: 55 start-page: 316 year: 2010 ident: 10.1016/j.ekir.2023.09.019_bib24 article-title: Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry publication-title: Am J Kidney Dis doi: 10.1053/j.ajkd.2009.10.048 – volume: 38 start-page: 933 year: 2010 ident: 10.1016/j.ekir.2023.09.019_bib5 article-title: Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in the pediatric intensive care unit publication-title: Crit Care Med doi: 10.1097/CCM.0b013e3181cd12e1 – volume: 375 start-page: 122 year: 2016 ident: 10.1016/j.ekir.2023.09.019_bib14 article-title: Initiation strategies for renal-replacement therapy in the Intensive Care Unit publication-title: N Engl J Med doi: 10.1056/NEJMoa1603017 – volume: 3 start-page: 948 year: 2008 ident: 10.1016/j.ekir.2023.09.019_bib20 article-title: Ascertainment and epidemiology of acute kidney injury varies with definition interpretation publication-title: Clin J Am Soc Nephrol doi: 10.2215/CJN.05431207 – volume: 29 start-page: 654 year: 2018 ident: 10.1016/j.ekir.2023.09.019_bib32 article-title: Clinical decision support for In-Hospital AKI publication-title: J Am Soc Nephrol doi: 10.1681/ASN.2017070765 – volume: 54 start-page: 1012 year: 2009 ident: 10.1016/j.ekir.2023.09.019_bib25 article-title: NGAL Meta-analysis Investigator Group. Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis publication-title: Am J Kidney Dis doi: 10.1053/j.ajkd.2009.07.020 – volume: 383 start-page: 240 year: 2020 ident: 10.1016/j.ekir.2023.09.019_bib13 article-title: Canadian Critical Care Trials Group, Australian and New Zealand Intensive Care Society Clinical Trials Group, et al. Timing of initiation of renal-replacement therapy in acute kidney injury publication-title: N Engl J Med – volume: 172 start-page: 257 year: 2018 ident: 10.1016/j.ekir.2023.09.019_bib17 article-title: Association between fluid balance and outcomes in critically ill children: a systematic review and meta-analysis publication-title: JAMA Pediatr doi: 10.1001/jamapediatrics.2017.4540 – volume: 57 start-page: 1752 year: 2011 ident: 10.1016/j.ekir.2023.09.019_bib26 article-title: The outcome of neutrophil gelatinase-associated lipocalin-positive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2010.11.051 – volume: 84 start-page: 42 year: 2013 ident: 10.1016/j.ekir.2023.09.019_bib34 article-title: The five “rights” of clinical decision support publication-title: J AHIMA – volume: 6 start-page: 1858 year: 2021 ident: 10.1016/j.ekir.2023.09.019_bib37 article-title: Recalibration of the renal angina index for pediatric septic shock publication-title: Kidney Int Rep doi: 10.1016/j.ekir.2021.04.022 – volume: 107 start-page: 1309 year: 2001 ident: 10.1016/j.ekir.2023.09.019_bib23 article-title: Outcome in children receiving continuous venovenous hemofiltration publication-title: Pediatrics doi: 10.1542/peds.107.6.1309 – volume: 376 start-page: 11 year: 2017 ident: 10.1016/j.ekir.2023.09.019_bib4 article-title: Epidemiology of acute kidney injury in critically ill children and young adults publication-title: N Engl J Med doi: 10.1056/NEJMoa1611391 – volume: 379 start-page: 1431 year: 2018 ident: 10.1016/j.ekir.2023.09.019_bib16 article-title: Timing of renal-replacement therapy in patients with acute kidney injury and sepsis publication-title: N Engl J Med doi: 10.1056/NEJMoa1803213 – volume: 58 start-page: 2301 year: 2011 ident: 10.1016/j.ekir.2023.09.019_bib28 article-title: Temporal relationship and predictive value of urinary acute kidney injury biomarkers after pediatric cardiopulmonary bypass publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2011.08.017 |
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| Title | Real-Time Acute Kidney Injury Risk Stratification – Biomarker Directed Fluid Management Improves Outcomes in Critically Ill Children and Young Adults |
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