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Analyzing Severe Acute Kidney Injury Using the Renal Angina Index

Rakasi S Reddy1, Mamata Devi Mohanty1, Sagar Parida2

  • 1Paediatrics, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, IND.

Cureus
|July 15, 2026
PubMed

Insights

The Renal Angina Index (RAI) reliably predicts acute kidney injury (AKI) in critically ill children. RAI-positive patients had higher rates of severe AKI, longer PICU stays, and increased mortality, confirming its predictive value.

Area of Science:

  • Pediatric Critical Care Medicine
  • Nephrology
  • Clinical Prediction Tools

Background:

  • Acute kidney injury (AKI) is a frequent complication in critically ill children within the pediatric intensive care unit (PICU).
  • The Renal Angina Index (RAI) is a validated tool for assessing AKI risk upon PICU admission.
  • RAI integrates objective kidney dysfunction markers and patient risk factors to predict severe AKI.

Purpose of the Study:

  • To evaluate the efficacy of the Renal Angina Index (RAI) for the early prediction of severe AKI in pediatric patients.
  • To assess the correlation between RAI positivity and the incidence of AKI in a pediatric intensive care setting.

Main Methods:

  • A prospective observational study was conducted in a pediatric intensive care unit (PICU) from 2020 to 2022.
  • Included were children aged 1 month to 14 years.
  • Renal Angina Index (RAI) scoring was performed on admission (day 0), and AKI development was monitored on day 3.

Main Results:

  • RAI positivity was observed in 44.9% of patients, with 37.7% developing AKI.
  • RAI-positive patients showed significantly higher rates of mechanical ventilation (71% vs. 9.6%), longer PICU stays (10.38 vs. 6.95 days), and increased mortality (20.4% vs. 7%).
  • A higher proportion of RAI-positive patients progressed to stages 1, 2, and 3 AKI compared to RAI-negative patients.

Conclusions:

  • The Renal Angina Index (RAI) serves as a reliable tool for predicting AKI in critically ill children.
  • Early identification of high-risk patients using RAI can potentially guide timely interventions.
Abstract

Keywords:
acute kidney injurycritical carepediatricrenal angina indexrisk predictor

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