The Renal Angina Index accurately predicted severe acute kidney injury in critically ill children, demonstrating a sensitivity of 82%, specificity of 87%, and an AUC of 0.90.
Cross-Sectional (n=278)
No
Does the Renal Angina Index accurately predict severe acute kidney injury in critically ill children compared to KDIGO criteria?
The Renal Angina Index is a highly sensitive and specific tool for early identification of severe AKI and associated poor outcomes in critically ill pediatric patients in resource-limited settings.
Estimación del efecto: AUC 0.90
OBJECTIVE: To evaluate the diagnostic accuracy of the Renal Angina Index (RAI) compared to Kidney Disease Improving Global Outcomes (KDIGO) criteria for early prediction of severe acute kidney injury (AKI) in critically ill children admitted to a tertiary care hospital in a low-middle-income country. METHODS: This cross-sectional study included critically ill children aged 1 month to 18 years admitted to the Pediatric Intensive Care Unit (PICU) at Aga Khan University Hospital, Karachi, from January to July 2021. Patients with chronic kidney disease or transferred after 24 h were excluded. RAI was calculated within 24 h of PICU admission, and its performance in predicting severe AKI (KDIGO stage 2 or 3) was compared with clinical outcomes such as need for renal replacement therapy (RRT), PICU length of stay, and mortality. RESULTS: Among 278 patients, 148 (53.2%) were RAI positive. RAI demonstrated a sensitivity of 82% and specificity of 87% for severe AKI, with an area under the ROC curve (AUC) of 0.90. RAI-positive patients had significantly higher requirements for diuretics (41.2% vs. 3.1%), RRT (10.8% vs. 0%), longer PICU stay (6.33 ± 5.28 vs. 3.71 ± 2.83 days), and higher mortality (23.6% vs. 1.5%) compared to RAI-negative patients. A threshold of RAI ≥ 8 provided the best balance between sensitivity and specificity. CONCLUSION: The Renal Angina Index is a highly sensitive and specific tool for early identification of severe AKI and associated poor outcomes in critically ill pediatric patients. Its implementation could significantly enhance AKI detection and management in resource-limited settings, where conventional biomarkers are often inaccessible.
Sagri et al. (Sat,) conducted a cross-sectional in Severe acute kidney injury (AKI) (n=278). Renal Angina Index (RAI) vs. KDIGO criteria / RAI-negative was evaluated on Severe AKI (KDIGO stage 2 or 3) (AUC 0.90). The Renal Angina Index accurately predicted severe acute kidney injury in critically ill children, demonstrating a sensitivity of 82%, specificity of 87%, and an AUC of 0.90.