Comparison of diagnostic criteria for acute kidney injury in critically ill children: a multicenter cohort study

• DOI: 10.1186/s13054-022-04083-0
• Publication Date: 2022-07-07T21:03:18Z
• Authors: Yuxian Kuai; Min Li; Jiao Chen; Zhen Jiang; Zhenjiang Bai; Hui Huang; Lin Wei; Ning Liu; Xiaozhong Li; Guoping Lu; Yanhong Li
• Keywords: Concordance

Substantial interstudy heterogeneity exists in defining acute kidney injury (AKI) and baseline serum creatinine (SCr). This study assessed AKI incidence its association with pediatric intensive care unit (PICU) mortality under different SCr definitions to determine the preferable approach for diagnosing AKI.In this multicenter prospective observational cohort study, was defined staged according Kidney Disease: Improving Global Outcome (KDIGO), modified KDIGO, reference change value optimized (pROCK) definitions. The calculated based on Schwartz formula or estimated as upper normative (NormsMax), admission (AdmSCr) AdmSCr. impacts of estimation methods incidence, severity distribution outcome were evaluated.Different estimates led differences from 6.8 25.7%; patients across all had higher PICU ranged 19.0 35.4%. A (25.7%) but lower (19.0%) observed KDIGO definition, which however overcome by (AKI incidence: 16.3%, mortality: 26.1%). Furthermore, consistencies stages between strong concordance rates > 90.0% weighted kappa values 0.8, increased pursuant staging Schwartz. When NormsMax used, an identical (13.6%), did not differ among stages. For pROCK, increase stage 3 associated after adjustment confounders.The vary depending definition method used. leads be highly relevant mortality, suggesting that it may critically ill children provides promise improving clinicians' ability diagnose AKI.