Renal angina index predicts fluid overload in critically ill children: an observational cohort study

BMC Nephrology

卷:22

Rajit K. Basu¹  Stephen M. Gorga²  Erin F. Carlton²  Joseph G. Kohne²  Ryan P. Barbaro² 

[1] Children’s Healthcare of Atlanta/Emory University;

[2] Department of Pediatrics, University of Michigan Medical School;

关键词: Fluid overload;    Acute kidney injury;    Renal angina index;    Kidney disease: improving global outcomes;   

DOI  :  10.1186/s12882-021-02540-6

来源: DOAJ

【 摘 要 】

Abstract Background Fluid overload and acute kidney injury are common and associated with poor outcomes among critically ill children. The prodrome of renal angina stratifies patients by risk for severe acute kidney injury, but the predictive discrimination for fluid overload is unknown. Methods Post-hoc analysis of patients admitted to a tertiary care pediatric intensive care unit (PICU). The primary outcome was the performance of renal angina fulfillment on day of ICU admission to predict fluid overload ≥15% on Day 3. Results 77/139 children (55%) fulfilled renal angina (RA+). After adjusting for covariates, RA+ was associated with increased odds of fluid overload on Day 3 (adjusted odds ratio (aOR) 5.1, 95% CI 1.23–21.2, p = 0.025, versus RA-). RA- resulted in a 90% negative predictive value for fluid overload on Day 3. Median fluid overload was significantly higher in RA+ patients with severe acute kidney injury compared to RA+ patients without severe acute kidney injury (% fluid overload on Day 3: 8.8% vs. 0.73%, p = 0.002). Conclusion Among critically ill children, fulfillment of renal angina was associated with increased odds of fluid overload versus the absence of renal angina and a higher fluid overload among patients who developed acute kidney injury. Renal angina directed risk classification may identify patients at highest risk for fluid accumulation. Expanded study in larger populations is warranted.

【 授权许可】

Unknown