Incidence and Etiology of Acute Kidney Injury in Southern India: Author’s Reply

Krishnamurthy, Sriram

doi:10.1007/s12098-013-1052-5

Cited by 4 publications

(1 citation statement)

References 5 publications

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“…Developed countries have reported an annual incidence of 3.3 cases per 100,000 children and a hospital mortality rate of up to 25-50% [ 6 , 7 ]. In developing countries, annual incidence falls between 30-50% [ 8 , 9 ]. Additionally, AKI leads to considerable healthcare utilization, with costs estimated between 8 billion dollars [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Acute Kidney Injury in Children With Shock: A Prospective Study

Abbas¹,

Laghari²,

Jurair³

et al. 2023

Cureus

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Background: The current definition of acute kidney injury (AKI) is based on serum creatinine (SrCr) and urine output, limited by delayed identification of such patients. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is considered an early diagnostic and highly predictive biomarker of AKI.Objective: To determine the diagnostic accuracy of NGAL for AKI compared with creatinine clearance for early detection of AKI in children with shock receiving inotropic support.Methods: Critically ill children requiring inotropic support in the pediatric intensive care unit were enrolled prospectively. SrCr and NGAL values were obtained three times at six, 12, and 48 hours after vasopressor initiation. Patients with AKI were defined as having loss of >25% renal function based on creatinine clearance within 48 hours. NGAL level of more than 150 ng/dl was suggestive of the diagnosis of AKI. Receiver operator characteristic curves were generated for NGAL and SrCr to compare the predictive ability of both at 0, 12, and 48 hours of starting vasopressor support.Results: A total of 94 patients were enrolled. The mean age was 43±50.95 months. Most common primary diagnoses were related to the cardiovascular system (46%). Twenty-nine patients (31%) died during the hospital stay. Thirty-four patients (36%) developed AKI within 48 hours following shock. The area under the curve (AUC) for NGAL at a cutoff of 150 ng/ml was 0.70, 0.74, and 0.73 at six-hour, 12-hour, and 48-hour follow-up, respectively. NGAL had a sensitivity of 85.3% and specificity of 50% at 0 hours of follow-up for diagnosis of AKI. Conclusion: Serum NGAL has better sensitivity and AUC compared to SrCr for early diagnosis of AKI in children admitted with shock.

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Section: Introductionmentioning

confidence: 99%

Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Acute Kidney Injury in Children With Shock: A Prospective Study

Abbas¹,

Laghari²,

Jurair³

et al. 2023

Cureus

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Acute kidney injury

Bholah¹,

Bunchman²

2020

Challenging Concepts in Paediatric Critical Care

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Acute kidney injury (AKI) affects roughly one-quarter of children in the Intensive Care Unit and is associated with increased morbidity and mortality. Progress made in classifying paediatric AKI has allowed for better recognition of this entity. Consideration of degree of fluid overload and other risk factors for mortality should influence the choice to initiate renal replacement therapy. And while not all patients with AKI will require renal replacement therapy, the modality needs to be chosen carefully. This book chapter aims to describe AKI, provide a brief overview of the aetiology and diagnosis of this process, describe biomarkers under study for diagnosing AKI, compare the modalities of renal replacement therapy, and touch upon prognostic factors and recent advances in the field.

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