Modification of the Cardiac Renal Angina Index for Predicting Adverse Kidney Events After Pediatric Cardiac Surgery.

Background: Pediatric cardiac surgery-associated acute kidney injury is common and associated with poor outcomes, but early prediction is challenging. The purpose of this study was to determine the performance of a modified cardiac renal angina index (cRAI) in predicting adverse renal events and whether biomarker integration (urine neutrophil gelatinase-associated lipocalin) enhances cRAI performance.

Methods: This was a 2-center prospective observational study in children ages 0 to 18 years admitted to the intensive care unit after cardiac surgery.

Growth after pediatric and neonatal acute kidney injury: a meta-analysis.

Background: Acute kidney injury (AKI) occurs commonly in critically ill children. The impact of AKI on pediatric growth outcomes has been sparsely described.

Objective: To compare growth in children with a history of AKI compared to those without AKI.

Hyperglycemia and kidney outcomes in critically ill children and young adults on continuous kidney replacement therapy.

Background: There are limited studies evaluating hyperglycemia in children treated with continuous kidney replacement therapy (CKRT). We evaluated the association of hyperglycemia with kidney outcomes in critically ill children treated with CKRT for acute kidney injury (AKI) or fluid overload.

Methods: Secondary analysis of the multicenter retrospective observational Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) study (34 centers, 9 countries).

Functional outcomes in pediatric patients on renal replacement therapy in a worldwide registry.

Background And Hypothesis: Mortality rates of children supported with continuous renal replacement therapy (CRRT) have improved, yet morbidity remains high. We aimed to evaluate the functional outcomes of children receiving CRRT using functional status scale (FSS). We hypothesized that children receiving CRRT will have worse FSS compared to their baseline, acquire new morbidity at hospital discharge and 6-and 12-months post discharge, and lack of renal recovery will contribute to worsening functional status.

Postnatal Steroid Exposure in Extremely Low Gestational Age Newborns and Kidney Function at 24 Months Corrected Age.

Background: Preterm birth is associated with low nephron endowment, with an increased risk of chronic kidney disease (CKD) later in life. Almost all pregnant women at risk for preterm delivery are given antenatal corticosteroids (ANS) to accelerate lung maturity in preterm neonates. Similar to ANS, postnatal corticosteroids are also given to improve lung function, but the impact on kidney function is unknown.

Thrombocytopenia in Children and Young Adults Undergoing Continuous Renal Replacement Therapy: A WE-ROCK Study.

Introduction: Thrombocytopenia in patients treated with continuous renal replacement therapy (CRRT) in adults is associated with mortality. Pediatric data are limited. The association between pre-CRRT thrombocytopenia and platelet decline at 24 h of CRRT with outcomes was evaluated.

Net Fluid Balance Impacts Pediatric Continuous Renal Replacement Therapy Liberation.

Objectives: The optimal fluid management strategy on continuous renal replacement therapy (CRRT) is unknown for critically ill children. The pace of ultrafiltration has been highlighted as a risk predictor for adverse outcomes in adult cohorts. Whether CRRT can cause dialytrauma through excessive ultrafiltration rates (UFRs) in children is undetermined.

Framework for Kidney Health Follow-Up Among Neonates With Critical Cardiac Disease: A Report From the Neonatal Kidney Health Consensus Workshop.

Acute kidney injury is common among neonates with critical cardiac disease. Risk factors and associations with kidney-related outcomes are heterogeneous and distinct from other neonates. As survival of children with critical cardiac disease increases to adulthood, the burden of chronic kidney disease is increasing.

Machine Learning-Based Prediction Model for ICU Mortality After Continuous Renal Replacement Therapy Initiation in Children.

Background: Continuous renal replacement therapy (CRRT) is the favored renal replacement therapy in critically ill patients. Predicting clinical outcomes for CRRT patients is difficult due to population heterogeneity, varying clinical practices, and limited sample sizes.

Objective: We aimed to predict survival to ICUs and hospital discharge in children and young adults receiving CRRT using machine learning (ML) techniques.

Current state of quality improvement research across cardiac ICUs: a Pediatric Cardiac Intensive Care Society (PCICS) survey.

Background: Outcomes for children with heart disease improved over the past decades. Quality improvement (QI) research in paediatric cardiac critical care is a key driver of improvement. The availability and variability of QI research across the field is unknown.

Biomarker-based acute kidney injury sub-phenotypes refine risk assessment in children undergoing cardiac surgery.

Background: Pediatric cardiac surgery-associated acute kidney injury (CS-AKI) is common with variable association with outcomes, possibly because transient serum creatinine (SCr) elevations are unrelated to kidney disease. Sub-phenotypes of CS-AKI with biomarker integration may provide prognostic enrichment. This study aims to determine if combining early postoperative urine neutrophil gelatinase-associated lipocalin (uNGAL) and SCr into sub-phenotypes strengthens associations with AKI and outcomes.

Analysis of ST segment alarms in children admitted to the paediatric and cardiac intensive care units and cardiac progressive care unit: a single-centre retrospective study.

ST segment monitoring in the adult population allows for the early detection of myocardial ischaemia. In children admitted to the paediatric intensive care unit (PICU), cardiac intensive care unit (CICU), and cardiac progressive care unit (CPCU), it is unclear if continuous ST segment alarm monitoring is necessary in all patients. All patients admitted to the PICU, CICU, and CPCU during the study period were included.

Kidney Health Monitoring in Neonatal Intensive Care Unit Graduates: A Modified Delphi Consensus Statement.

Importance: Kidney disease is common in infants admitted to the neonatal intensive care unit (NICU). Despite the risk of chronic kidney disease (CKD) in infants discharged from the NICU, neither evidence- nor expert-based recommendations exist to guide clinical care after discharge.

Objective: To develop recommendations for risk stratification and kidney health monitoring among infants after discharge from the NICU.

Characteristics and Outcomes of Children and Young Adults With Sepsis Requiring Continuous Renal Replacement Therapy: A Comparative Analysis From the Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK).

Objectives: Pediatric sepsis-associated acute kidney injury (AKI) often requires continuous renal replacement therapy (CRRT), but limited data exist regarding patient characteristics and outcomes. We aimed to describe these features, including the impact of possible dialytrauma (i.e.

Characteristics and outcomes of children ≤ 10 kg receiving continuous kidney replacement therapy: a WE-ROCK study.

Background: Continuous kidney replacement therapy (CKRT) is often used for acute kidney injury (AKI) or fluid overload (FO) in children ≤ 10 kg. Intensive care unit (ICU) mortality in children ≤ 10 kg reported by the prospective pediatric CRRT (ppCRRT, 2001-2003) registry was 57%. We aimed to evaluate characteristics associated with ICU mortality using a contemporary registry.

Prediction of cardiac surgery associated acute kidney injury using response to loop diuretic and urine neutrophil gelatinase associated lipocalin.

Background: Cardiac surgery associated acute kidney injury (CS-AKI) is common. Urine response to loop diuretic and urine neutrophil gelatinase associated lipocalin (uNGAL) are separately associated with CS-AKI. We aimed to determine whether urine response to loop diuretic and uNGAL together were associated with postoperative day 2-4 CS-AKI.

Kinetics of Renin Concentrations in Infants Undergoing Congenital Cardiac Surgery.

Background: Elevated renin has been shown to predict poor response to standard vasoactive therapies and is associated with poor outcomes in adults. Similarly, elevated renin was associated with mortality in children with septic shock. Renin concentration profiles after pediatric cardiac surgery are unknown.

Periods of low renal perfusion pressure are associated with acute kidney injury following paediatric cardiac surgery.

Introduction: Acute kidney injury is associated with worse outcomes after cardiac surgery. The haemodynamic goals to ameliorate kidney injury are not clear. Low post-operative renal perfusion pressure has been associated with acute kidney injury in adults.