Related Experiment Video
Updated: Jan 19, 2026
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Defining pediatric community-acquired acute kidney injury: an observational study
Erika R O'Neil1, Sridevi Devaraj2, Lesby Mayorquin3
1Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. erika.oneil.md@gmail.com.
Insights
Detecting pediatric acute kidney injury (AKI) early is crucial. Using age- and gender-based creatinine norms, instead of only baseline creatinine, helps identify community-acquired AKI (CA-AKI) in children, even without prior creatinine levels.
Area of Science:
- Pediatric Nephrology
- Clinical Diagnostics
- Biomarker Research
Background:
- Pediatric acute kidney injury (AKI) is linked to significant long-term health issues.
- Early detection of AKI improves patient outcomes.
- Diagnosing community-acquired AKI (CA-AKI) in pediatric emergency departments is challenging due to the frequent absence of baseline creatinine levels.
Purpose of the Study:
- To evaluate the efficacy of age- and gender-based creatinine norms as a surrogate for baseline creatinine in diagnosing CA-AKI.
- To compare the diagnostic yield of traditional baseline creatinine versus normative creatinine values for CA-AKI detection.
Main Methods:
- Retrospective cross-sectional study involving children aged 1 month to 18 years.
- Creatinine levels were analyzed from pediatric emergency department encounters.
- Comparison of CA-AKI diagnosis using traditional baseline creatinine versus age- and gender-specific creatinine upper limits.
Main Results:
- Using traditional baseline creatinine, 14.7% of encounters showed CA-AKI.
- Applying age- and gender-based creatinine norms as a surrogate baseline identified CA-AKI in 1.5% of encounters.
- An additional 178 CA-AKI cases were identified using only age- and gender-based norms when baseline creatinine was unavailable.
Conclusions:
- Age- and gender-based creatinine norms serve as a viable surrogate baseline for diagnosing CA-AKI in pediatric populations.
- This approach facilitates CA-AKI detection in all children, irrespective of baseline creatinine availability.
- Utilizing normative creatinine values may enable earlier identification of pediatric CA-AKI.
Background:
Pediatric acute kidney injury (AKI) is associated with long-term morbidity and mortality; however, outcomes improve when AKI is detected earlier. Current definitions of AKI use baseline creatinine; community-acquired AKI (CA-AKI) is difficult to define and detect in the pediatric emergency department (ED) when no baseline creatinine is available. Our objective was to compare age- and gender-based creatinine norms to the traditional baseline (lowest creatinine in previous 3 months) to diagnose CA-AKI.
Methods:
This was a retrospective cross-sectional study conducted in children 1 month-18 years of age seen in the pediatric ED in whom a creatinine was obtained.
Results:
Per the Kidney Disease Improving Global Outcomes AKI definition in encounters with baseline creatinine available, 343/2338 (14.7%) had CA-AKI. When the upper limit of the age- and gender-based creatinine norm was applied as a surrogate baseline creatinine, CA-AKI was diagnosed in 1.5% of encounters (239/15,486). Additionally, CA-AKI was diagnosed in 178 cases using the upper limit of age- and gender-based creatinine norms only, as these cases did not have a baseline creatinine.
Conclusions:
Age- and gender-based creatinine norms can be applied as a surrogate baseline to detect CA-AKI in all children regardless of whether baseline creatinine is available, potentially detecting it earlier.
More Related Videos
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:22Acute Kidney Injury I: Introduction
01:29Acute Kidney Injury II: Pathophysiology
01:29Acute Kidney Injury III: Clinical Manifestations
01:20Acute Kidney Injury V: Interprofessional Care
01:22Acute Kidney Injury VI: Nursing Management