Chisavu, F.; Gafencu, M.; Chisavu, L.; Stroescu, R.; Schiller, A. Kinetic Estimated Glomerular Filtration Rate in Predicting Paediatric Acute Kidney Disease. J. Clin. Med.2023, 12, 6314.
Chisavu, F.; Gafencu, M.; Chisavu, L.; Stroescu, R.; Schiller, A. Kinetic Estimated Glomerular Filtration Rate in Predicting Paediatric Acute Kidney Disease. J. Clin. Med. 2023, 12, 6314.
Chisavu, F.; Gafencu, M.; Chisavu, L.; Stroescu, R.; Schiller, A. Kinetic Estimated Glomerular Filtration Rate in Predicting Paediatric Acute Kidney Disease. J. Clin. Med.2023, 12, 6314.
Chisavu, F.; Gafencu, M.; Chisavu, L.; Stroescu, R.; Schiller, A. Kinetic Estimated Glomerular Filtration Rate in Predicting Paediatric Acute Kidney Disease. J. Clin. Med. 2023, 12, 6314.
Abstract
Kinetic estimation of glomerular filtration rate (KeGFR) proved its utility in predicting acute kidney injury (AKI) in both adults and children. Our objective is to assess the clinical utility of KeGFR in predicting AKI severity and progression to acute kidney disease (AKD) in patients already diagnosed with AKI and to examine major adverse kidney events at 30 days (MAKE30). We retrospectively calculated the KeGFR in the first 24 hours of identified AKI (KeGFR1) and in the 24 hours prior to AKD (KeGFR2) in all admitted children under 18 years old. The cohort consisted of 803 patients with AKI. We proposed a new classification of KeGFR stages, from 1 to 5, and assessed the predictive value of KeGFR stages for AKD development and MAKE30. AKI severity was associated with lower KeGFRs. KeGFR1 and KeGFR2 predicted AKD with AUC values between 0.777 and 0.841 respectively, p<0.001. KeGFR2 had the best performance in predicting MAKE30 (AUC of 0.819) with a sensitivity of 66.67% and specificity 87.7%. KeGFR1 stage 3, 4 and 5 increased the risk of AKD by 3.07, 6.56 and 28.07 times respectively while KeGFR2 stage 2, 3, 4 and 5 increased the risk of AKD 2.79, 3.58, 32.75 and 80.14 times fold. Stage 5 KeGFR1 and KeGFR2 stages 3, 4 and 5 increased the risk of MAKE30 by 7.77, 4.23. 5.89 and 69.42 times in the adjusted models. KeGFR proved to be a useful tool in AKI settings. KeGFR dynamics can predict AKI severity, duration and outcomes.
Keywords
AKI; AKD; kinetic GFR; children; MAKE30
Subject
Medicine and Pharmacology, Pediatrics, Perinatology and Child Health
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
