Pediatric anesthesia & critical care
The outcome of acute kidney injury substages based on urinary cystatin C in critically ill children
Authors' conclusion
Sub-AKI defined/based on uCysC occurred in 20.2% of patients without AKI and was associated with a risk of death close to patients with AKI substage A. Urinary CysC-positive AKI substage B occurred in 50% of AKI patients and was more likely to have classical AKI stage 3 and was associated with the highest risk of mortality.
Study context
- Population
- Critically ill children in the pediatric intensive care unit (PICU) of four tertiary hospitals in China
- Participants
- 793 children · 4 tertiary hospitals
- Exposure
- Sub-AKI and acute kidney injury (AKI) substages A and B vs non-AKI
- Sub-AKIn = 124
- AKI substage An = 90
- AKI substage Bn = 90
- Outcome
- PICU mortality
- Follow-up
- 30 days
Main finding
As reported in the abstract
30-day PICU mortality
- Sub-AKI vs Non-AKI · significant after adjustment for confounders
- aHR 2.42
- AKI substage B vs Non-AKI · significant after adjustment for confounders
- aHR 2.83
- AKI substage B vs Sub-AKI
- HR 3.10
- AKI substage B vs AKI substage A
- HR 3.19
Observational data: associations, not effects.
Further findings
| Outcome | Sub-AKI | AKI substage B |
|---|---|---|
| Incidence of AKI substagesSubstage B % of AKI patients | 15.6% | 50% |
- Incidence of AKI substages — AKI (KDIGO)
- 180 (22.7%)
Incidence of AKI substages
- Substage B more likely classical AKI stage 3 vs substage A
Original publication
The outcome of acute kidney injury substages based on urinary cystatin C in critically ill children. Ann Intensive Care. Published 28 March 2023. doi:10.
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