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Association between serum lactate trajectories and short-term mortality in pediatric acute kidney injury patients

Xiaodong Jiang1, Yu Zhang2, Hua Lu3

  • 1Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China; Department of Pediatrics, Guizhou Children's Hospital, Zunyi, Guizhou, China.

Jornal De Pediatria
|August 17, 2026
PubMed

Insights

Early lactate levels and their changing patterns in critically ill children with acute kidney injury (AKI) predict 30-day mortality. Identifying these lactate trajectories aids in early risk stratification for pediatric AKI patients.

Area of Science:

  • Pediatric critical care medicine
  • Nephrology
  • Biomarkers

Background:

  • Acute kidney injury (AKI) is a significant threat to critically ill children.
  • Serum lactate is a key indicator of tissue oxygenation and perfusion.
  • Understanding lactate dynamics is crucial for predicting outcomes in pediatric AKI.

Purpose of the Study:

  • To investigate the association between early dynamic lactate trajectories in the pediatric intensive care unit (PICU) and 30-day mortality in pediatric AKI patients.
  • To evaluate the prognostic value of admission lactate levels and distinct lactate patterns.

Main Methods:

  • Retrospective analysis of 1056 critically ill children with AKI admitted to the PICU.
  • Utilized multivariable Cox regression, restricted cubic spline (RCS), and latent growth mixture models (LGMM).
  • Assessed association between admission lactate, lactate trajectories, and 30-day mortality.

Main Results:

  • Admission lactate levels were independently associated with increased 30-day mortality (HR 1.13).
  • Three distinct lactate trajectories were identified: high decreasing, low stable, and persistent high.
  • Both high decreasing (HR 3.37) and persistent high (HR 6.24) lactate trajectories were linked to significantly higher mortality compared to the low stable group.

Conclusions:

  • Serum lactate levels and their early dynamic changes are valuable prognostic indicators in pediatric AKI.
  • Identifying specific lactate trajectories allows for early risk stratification.
  • These findings can guide individualized management strategies for pediatric AKI patients.
Abstract

Keywords:
Acute kidney injuryCritical careLactatesMortalityPediatricsTrajectory analysis

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