Pediatric anesthesia & critical care
Increasing angiotensin-converting enzyme concentrations and absent angiotensin-converting enzyme activity are associated with adverse kidney outcomes in pediatric septic shock
Authors' conclusion
ACE activity is diminished in pediatric septic shock, appears uncoupled from ACE concentrations, and is associated with adverse kidney outcomes.
Study context
- Population
- Children aged 1 week-18 years with septic shock
- Participants
- 72 children
- Comparison
- Composite outcome vs No composite outcome
- Composite outcomen = 27
- Primary endpoint
- Composite outcome:
- Severe persistent AKI
- Kidney replacement therapy use
- Mortality
- Follow-up
- Day 1-7
Methodological detailssecondary analysis of a multicentre observational study
- Secondary analysis of a multicentre observational study
Primary result
As reported in the abstract
Association of renin-angiotensin-aldosterone system (RAAS) components with composite outcome
Adjusted odds ratio (95% CI)P value
Increasing ACE concentrations
1.01(1.002–1.03)
P = 0.015Undetectable ACE activity
6.6(1.2–36.1)
P = 0.031- Undetectable angiotensin-converting enzyme (ACE) activity, composite vs no composite
- P = 0.025
- Day 1 renin + prorenin, composite vs no composite
- P < 0.001
- ACE concentrations, composite vs no composite
- P = 0.019
Further findings
Day 1 renin + prorenin by ACE activity
P = 0.017
Prevalence of undetectable ACE activity (< 2.41 U/L) on Day 1
- Undetectable ACE activity
- 50/72 (69%)
- Developed composite outcome
- 27/72 (38%)
Day 1 renin + prorenin by ACE activity
- ACE concentrations no different between groups
Original publication
Increasing angiotensin-converting enzyme concentrations and absent angiotensin-converting enzyme activity are associated with adverse kidney outcomes in pediatric septic shock. Crit Care. Published 12 June 2023. doi:10.
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