Renal Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference

Area of Science:

• Pediatric Critical Care Medicine
• Nephrology
• Clinical Epidemiology

Background:

• Renal dysfunction is a significant predictor of adverse outcomes in critically ill children.
• Existing criteria for defining pediatric renal dysfunction lack consensus and contemporary validation.

Purpose of the Study:

• To systematically review evidence for criteria defining renal dysfunction in critically ill children.
• To develop consensus-based criteria for identifying renal dysfunction in this population.

Main Methods:

• A systematic review of PubMed and Embase databases (1992-2020) was conducted.
• Studies included critically ill children, focusing on renal dysfunction assessment and outcomes.
• Exclusion criteria comprised adult studies, premature infants, animal research, reviews, and non-English publications.

Main Results:

• Consensus criteria for renal dysfunction include specific thresholds for urine output, serum creatinine increase, estimated glomerular filtration rate (eGFR), fluid overload, and initiation of renal replacement therapy (RRT).
• Criteria address persistent renal dysfunction and high risk of renal dysfunction.
• The review identified limitations including the observational and often retrospective nature of included studies.

Conclusions:

• Consensus criteria for defining renal dysfunction in critically ill children have been established.
• These criteria aim to standardize identification and facilitate research into adverse outcomes.
• Further research may be needed to validate these criteria prospectively.