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. 2022 Jan 1;149(1 Suppl 1):S66-S73.
doi: 10.1542/peds.2021-052888J.

Renal Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference

Julie C Fitzgerald  1 , Rajit K Basu  2 , Dana Y Fuhrman  3 , Stephen M Gorga  4 , Amanda B Hassinger  5 , L Nelson Sanchez-Pinto  6 , David T Selewski  7 , Scott M Sutherland  8 , Ayse Akcan-Arikan  9 ; Pediatric Organ Dysfunction Information Update Mandate (PODIUM) Collaborative
Collaborators, Affiliations

Renal Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference

Julie C Fitzgerald et al. Pediatrics. .

Abstract

Context: Renal dysfunction is associated with poor outcomes in critically ill children.

Objective: To evaluate the current evidence for criteria defining renal dysfunction in critically ill children and association with adverse outcomes. To develop contemporary consensus criteria for renal dysfunction in critically ill children.

Data sources: PubMed and Embase were searched from January 1992 to January 2020.

Study selection: Included studies evaluated critically ill children with renal dysfunction, performance characteristics of assessment tools for renal dysfunction, and outcomes related to mortality, functional status, or organ-specific or other patient-centered outcomes. Studies with adults or premature infants (≤36 weeks' gestational age), animal studies, reviews, case series, and studies not published in English with inability to determine eligibility criteria were excluded.

Data extraction: Data were extracted from included studies into a standard data extraction form by task force members.

Results: The systematic review supported the following criteria for renal dysfunction: (1) urine output <0.5 mL/kg per hour for ≥6 hours and serum creatinine increase of 1.5 to 1.9 times baseline or ≥0.3 mg/dL, or (2) urine output <0.5 mL/kg per hour for ≥12 hours, or (3) serum creatinine increase ≥2 times baseline, or (4) estimated glomerular filtration rate <35 mL/minute/1.73 m2, or (5) initiation of renal replacement therapy, or (6) fluid overload ≥20%. Data also support criteria for persistent renal dysfunction and for high risk of renal dysfunction.

Limitations: All included studies were observational and many were retrospective.

Conclusions: We present consensus criteria for renal dysfunction in critically ill children.

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Conflict of interest statement

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

Figure 1.
Figure 1.
Study flow diagram according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols recommendations.
See this image and copyright information in PMC

References

    1. Hessey E, Perreault S, Dorais M, Roy L, Zappitelli M. Acute Kidney Injury in Critically Ill Children and Subsequent Chronic Kidney Disease. Can J Kidney Health Dis. 2019;6:2054358119880188. - PMC - PubMed
    1. Kaddourah A, Basu RK, Bagshaw SM, Goldstein SL, Investigators A. Epidemiology of Acute Kidney Injury in Critically Ill Children and Young Adults. N Engl J Med. 2017;376(1):11–20. - PMC - PubMed
    1. Sutherland SM, Byrnes JJ, Kothari M, et al. AKI in hospitalized children: comparing the pRIFLE, AKIN, and KDIGO definitions. Clin J Am Soc Nephrol. 2015;10(4):554–561. - PMC - PubMed
    1. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Section 2: AKI Definition. Kidney Int Suppl (2011). 2012;2(1):19–36. - PubMed
    1. Kaddourah A, Basu RK, Goldstein SL, Sutherland SM, Assessment of Worldwide Acute Kidney Injury RAaEI. Oliguria and Acute Kidney Injury in Critically Ill Children: Implications for Diagnosis and Outcomes. Pediatr Crit Care Med. 2019;20(4):332–339. - PubMed

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