scholarly journals Validation of Renal Angina Index (RAI) to improve the prediction of Acute Kidney Injury (AKI) in critically ill children admitted to paediatric intensive care unit (PICU)

2017 ◽  
Vol 4 (6) ◽  
pp. 2158
Author(s):  
Jakanattane V. ◽  
Sivakumar E. ◽  
Rajkumar D. ◽  
Kulandaivel M.
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Paediatric Intensive Care Unit ◽  
Prospective Observational Study ◽  
Pediatric Population ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Reliable Prediction ◽  
Renal Angina Index ◽  
Renal Angina

Background: Acute Kidney Injury (AKI) is associated with poor outcome in critically ill children. Reliable prediction of severe AKI may optimize treatment. Here we operationalize the concept of renal angina with Renal Angina Index (RAI). The objective of this study was to validate RAI for prediction of severe AKI on Day 3 of admission.Methods: A prospective observational study including children 1 month to 12 years admitted to PICU at ICH and RC, Madurai over 6 months. Clinical data, urine output (ml/kg/hour), serial S. creatinine values were collected. Renal angina positive was defined as RAI score ≥8.Results: Overall incidence of AKI was 27.8%. Day 0 RAI ≥8 was 42.9% of which 56.1% developed day 3 AKI. RAI ≤8 had high NPV of 93% for Day 3 AKI. Renal angina concept using RAI predicts subsequent severe AKI. RAI provides clinically feasible and applicable methodology to identify critically ill children at risk of severe AKI lasting beyond functional injury. RAI may potentially reduce capricious AKI biomarker use.Conclusions: The use of renal angina to stratify patients for enrollment in biomarker or therapy trials may create the uniformity required to properly analyze AKI in pediatric population. We believe that renal angina is a clinical adjunct that will lead to the optimization of AKI biomarker performance across the wide-ranging heterogeneity that exists across the general pediatric PICU population. RAI may potentially reduce capricious AKI biomarker use by identifying patients in whom further testing would be most beneficial.

scholarly journals Urinary NGAL incorporation into Renal Angina Index for early detection of acute kidney injury in critically ill children

2019 ◽  
Vol 3 (2) ◽  
pp. 093-099 ◽  
Author(s):  
Ali Mohammed Abu Zeid ◽  
Doaa Youssef Mohammed* ◽  
Amal Saeed AbdAlazeem ◽  
Anas Saad Elsayed Mohammed Seddeeq ◽  
Ashraf Mohamed Elnaany
Keyword(s):  
Acute Kidney Injury ◽  
Early Detection ◽  
Critically Ill ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Urinary Ngal ◽  
Renal Angina Index ◽  
Renal Angina

scholarly journals Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children

2014 ◽  
Vol 85 (3) ◽  
pp. 659-667 ◽  
Author(s):  
Rajit K. Basu ◽  
Michael Zappitelli ◽  
Lori Brunner ◽  
Yu Wang ◽  
Hector R. Wong ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Renal Angina Index ◽  
Renal Angina

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

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stephen M. Gorga ◽  
Erin F. Carlton ◽  
Joseph G. Kohne ◽  
Ryan P. Barbaro ◽  
Rajit K. Basu
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Fluid Overload ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Poor Outcomes ◽  
Renal Angina Index ◽  
Renal Angina

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.

scholarly journals Clinico-etiological profile of acute kidney injury in children admitted to paediatric intensive care unit of a tertiary care centre

2017 ◽  
Vol 5 (11) ◽  
pp. 4959
Author(s):  
Jakanattane V. ◽  
Mathivanan M.
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Paediatric Intensive Care Unit ◽  
Kidney Injury ◽  
Paediatric Intensive Care ◽  
Renal Recovery ◽  
Research Centre ◽  
Critically Ill Children

Background: Acute Kidney Injury (AKI) refers to a reversible accumulation of urea, creatinine and nitrogenous waste products and disturbances in maintenance of fluid and electrolyte homeostasis. The incidence of AKI continues to increase in the Paediatric age group particularly in critically ill children with the etiology shifting from primary renal disorders to multifactorial cause. The objective of the study to determine the incidence, clinical profile and outcome of AKI in critically ill children using p-RIFLE criteria.Methods: A prospective observational study was done with 342 children aged between 1-12 years, admitted in Paediatric Intensive Care Unit (PICU) of Institute of Child Health and Research Centre, Madurai Medical College, Madurai during July 2015 to June 2016.Results: The overall incidence of AKI among critically ill children was 30.1%. The mortality rate was 43.7% and 20.7% patients with AKI had partial renal recovery at the time of discharge. 27.2% patients required renal replacement therapy (RRT). Infectious causes 57.3% (Sepsis, Meningoencephalitis, Bronchopneumonia) dominated the etiological profile.Conclusions: Incidence of AKI is high in critically-ill children. AKI continues to be associated with adverse outcomes, including high mortality and partial renal recovery.

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