Background: Predicting the prognosis of patients admitted to the pediatric intensive care unit (PICU) is very important in determining further management and resource allocation. The prognostication of critically ill children can be challenging; hence, accurate methods for predicting outcomes are needed.
Purpose: To evaluate the role of microalbuminuria at admission as a prognostic marker in comparison to standard Pediatric Risk of Mortality (PRISM) and Pediatric Logistic Organ Dysfunction (PELOD) mortality scores in children admitted to the PICU.
Methods: This cross-sectional study was conducted from January 2015 to October 2016. Eighty-four patients aged 1 month to 18 years admitted to the PICU of teaching hospitals for more than 24 hours were enrolled by convenience sampling method. Microalbuminuria was estimated by spot urinary albumin-creatinine ratio. PRISM and PELOD scores were calculated using an online calculator. Outcome measures were PICU length of stay, inotrope usage, multiorgan dysfunction, and survival. ACR was compared with mortality scores for predicting survival.
Results: Microalbuminuria was present in 79.8% with a median value of 85 mg/g (interquartile range, 41.5-254 mg/g). A positive correlation was found between albumin-creatinine ratio and PICU length of stay (P=0.013, r=0.271). Albumin-creatinine ratio was significantly associated with organ dysfunction (P=0.004) and need for inotropes (P=0.006). Eight deaths were observed in the PICU. The area under the curve for mortality for albumin-creatinine ratio (0.822) was comparable to that for PRISM (0.928) and PELOD (0.877). Albumin-creatinine ratio >109 mg/g predicted mortality with a sensitivity of 87.5% and specificity of 63.2%.
Conclusion: Microalbuminuria is a good predictor of PICU outcomes comparable with mortality scores.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027344 | PMC |
| http://dx.doi.org/10.3345/kjp.2018.07220 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Factors Associated with Microalbuminuria among Children with Sickle Cell Disease in a Tertiary Centre in South-South Nigeria.
Niger Med J
January 2025
Department of Haematology and Blood Transfusion, Rivers State University Teaching Hospital & Faculty of Basic Clinical Sciences, Rivers State University, Nigeria.
Background: Microalbuminuria, an early indicator of kidney damage in Sickle Cell Disease (SCD) patients, is linked to a heightened risk of chronic kidney disease (CKD) in adulthood. This study investigates the determinants of microalbuminuria in paediatric SCD patients in South-South Nigeria.
Methodology: This cross-sectional study was conducted over six months at the Rivers State University Teaching Hospital, Nigeria, involving 60 children with [HbSS genotype, SCD] in a steady state.
Objectives: This clinical study assessed the three-year, long-term effects of esaxerenone, a non-steroidal aldosterone receptor blocker, on Japanese patients with type 2 diabetes, diabetic kidney disease, and hypertension who were receiving renin-angiotensin system inhibitors.
Materials And Methods: Data from a computerized diabetic care database were used to retrospectively compare esaxerenone users (Group A) with non-esaxerenone users (Group B). Propensity score weighting was applied to Group B.
First real-world evidence of sparsentan efficacy in patients with IgA nephropathy treated with SGLT2 inhibitors.
Clin Kidney J
January 2025
Department of General Internal Medicine and Nephrology, Robert Bosch Hospital Stuttgart, Stuttgart, Germany.
Background: Sparsentan, a dual-acting antagonist for both the angiotensin II receptor type 1 and the endothelin receptor type A, has emerged as a promising therapeutic agent for the treatment of IgA nephropathy (IgAN). Following the publication of the PROTECT trial, sparsentan recently received approval for the treatment of IgAN in Europe. However, it remains uncertain whether an additive effect can be observed in the context of existing treatment with sodium-glucose co-transporter 2 (SGLT2) inhibitors, given that the PROTECT study did not investigate this dual therapy approach.
View Article and Find Full Text PDFNeurofilament light chain - Can it be measured in urine?
Clin Chim Acta
January 2025
Department of Clinical Biochemistry, Aarhus University Hospital, Palle Juul Jensens Boulevard 99 8200 Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University 8000 Aarhus C, Denmark.
Objective: This exploratory study investigates if neurofilament light chain (NfL) is excreted in the urine and whether this depends on plasma NfL (pNfL) levels and kidney function in terms of eGFR and U-albumin-creatinine ratio (uACR).
Methods: Using a computer algorithm, we identified excess urine and plasma from routine testing of uACR and eGFR in patients 45-50 years old. Up to 17 paired urine-plasma samples in each of six categories of kidney function defined by uACR and eGFR were analysed for NfL, and the urinary NfL-creatinine ratio (uNCR) was calculated to correct for urine dilution.
High prevalence of unrecognized chronic kidney disease in the Lolland-Falster Health Study: a population-based study in a rural provincial area of Denmark.
Eur J Public Health
January 2025
Department of Nephrology and Endocrinology, Rigshospitalet, Copenhagen, Denmark.
Chronic kidney disease (CKD) affects 10-15% globally and is a marked independent risk factor for cardiovascular disease. Prevalence estimations are essential for public health planning and implementation of CKD treatment strategies. This study aimed to estimate the prevalence and stages of CKD in the population-based Lolland-Falster Health Study, set in a rural provincial area with the lowest socioeconomic status in Denmark.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!