Abstract:
:BackgroundAcute kidney injury (AKI) is common in pediatric inpatients and is associated with increased morbidity, mortality, and length of stay. Its early identification can reduce severity.MethodsTo create and validate an electronic health record (EHR)-based AKI screening tool, we generated temporally distinct development and validation cohorts using retrospective data from our tertiary care children's hospital, including children aged 28 days through 21 years with sufficient serum creatinine measurements to determine AKI status. AKI was defined as 1.5-fold or 0.3 mg/dl increase in serum creatinine. Age, medication exposures, platelet count, red blood cell distribution width, serum phosphorus, serum transaminases, hypotension (ICU only), and pH (ICU only) were included in AKI risk prediction models.ResultsFor ICU patients, 791/1,332 (59%) of the development cohort and 470/866 (54%) of the validation cohort had AKI. In external validation, the ICU prediction model had a c-statistic=0.74 (95% confidence interval 0.71-0.77). For non-ICU patients, 722/2,337 (31%) of the development cohort and 469/1,474 (32%) of the validation cohort had AKI, and the prediction model had a c-statistic=0.69 (95% confidence interval 0.66-0.72).ConclusionsAKI screening can be performed using EHR data. The AKI screening tool can be incorporated into EHR systems to identify high-risk patients without serum creatinine data, enabling targeted laboratory testing, early AKI identification, and modification of care.
journal_name
Pediatr Resjournal_title
Pediatric researchauthors
Wang L,McGregor TL,Jones DP,Bridges BC,Fleming GM,Shirey-Rice J,McLemore MF,Chen L,Weitkamp A,Byrne DW,Van Driest SLdoi
10.1038/pr.2017.116subject
Has Abstractpub_date
2017-09-01 00:00:00pages
465-473issue
3eissn
0031-3998issn
1530-0447pii
pr2017116journal_volume
82pub_type
杂志文章abstract::Neutrophils (PMN) from newborn calves generate significantly less superoxide anion (O2-) than do their adult counterparts after stimulation with direct protein kinase C agonists. To better understand this observation, we compared the activity and kinetics of NADPH oxidase in membrane fractions from phorbol 12-myristat...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199010000-00005
更新日期:1990-10-01 00:00:00
abstract::The role of microbial colonization is indispensable for keeping a balanced immune response in life. However, the events that regulate the establishment of the microbiota, their timing, and the way in which they interact with the host are not yet fully understood. Factors such as gestational age, mode of delivery, envi...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1038/pr.2015.54
更新日期:2015-06-01 00:00:00
abstract::Skin fibroblasts derived from 6 patients with cystic fibrosis (CF), 1-6 months old, and from 6 age matched donors were investigated for their ability to accumulate cyclic adenosine 3':5'-monophosphate (c-AMP) in response to isoproterenol and prostaglandin E1 (PGE1) using strictly defined culture conditions. In order t...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198003000-00018
更新日期:1980-03-01 00:00:00
abstract::Medium chain acyl-CoA dehydrogenase deficiency (MCAD) is a defect in the mitochondrial oxidation of fatty acids. The disorder typically presents with episodes of vomiting and hypoglycemia, sometimes with changes in mental status and hepatic failure. These Reye's-like features may culminate in coma and death. Stress, i...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199505000-00021
更新日期:1995-05-01 00:00:00
abstract::A longitudinal study describes the pattern of appearance of eight primitive reflexes in a population of 47 viable extremely premature infants, beginning as early as 25 wk postconceptional age (PCA). Infants were examined weekly, from 1 wk of age until discharge from the neonatal intensive care unit. Primitive reflexes...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198612000-00018
更新日期:1986-12-01 00:00:00
abstract::Infants dying with bronchopulmonary dysplasia (BPD) demonstrate increased numbers of pulmonary neuroendocrine cells (PNEC). These infants also possess altered airway epithelial and smooth muscle dimensions reminiscent of oxygen-exposed animals. Because the pathogenesis of BPD involves oxygen toxicity, we hypothesized ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199710000-00020
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Neonatal encephalopathy (NE) carries high risk for neurodevelopmental impairments. Therapeutic hypothermia (TH) reduces this risk, particularly for moderate encephalopathy (ME). Nevertheless, these infants often have subtle functional deficits, including abnormal memory function. Detection of deficits at the...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2016.169
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:A growing body of evidence defines inflammation as a hallmark feature of disease pathogenesis of Duchenne muscular dystrophy. To tailor potential immune modulatory interventions, a better understanding of immune dysregulation in Duchenne muscular dystrophy is needed. We now asked whether dystrophin deficienc...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-019-0427-3
更新日期:2019-08-01 00:00:00
abstract::To assess the National Institutes of Health extramural activity in the area of pediatric nephrology research, the rate of submission of grant applications to the National Institutes of Health and available indicators of the quality of these applications were analyzed. This was accomplished by utilizing the grant appli...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198511000-00001
更新日期:1985-11-01 00:00:00
abstract::Several hours after an hypoxic-ischemic injury to the developing brain, hyperemia, then seizures, edema, and infarction can develop. The roles of nitric oxide (NO) synthesis and excitotoxin accumulation during these later phases of injury are not known. The time course of extracellular levels of amino acids within the...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199605000-00008
更新日期:1996-05-01 00:00:00
abstract::Our aim was to obtain a better understanding of the differences between breast-feeding and bottle-feeding, particularly with regard to how sucking performance changes from nonnutritive sucking (NNS) to nutritive sucking (NS). Twenty-two normal term infants were studied while breast-feeding at 4 and 5 d postpartum. Fiv...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.pdr.0000214993.82214.1c
更新日期:2006-05-01 00:00:00
abstract::Low IGF-I levels are found in patients with chronic liver disease, but it is not known whether these reductions in IGF-I are secondary to hepatic dysfunction or to malnutrition. To determine whether malnutrition associated with hepatic dysfunction causes the decrease in these levels, serum and liver IGF-I concentratio...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198911000-00009
更新日期:1989-11-01 00:00:00
abstract::Serum diamine oxidase (DAO) activities were measured in 20 control patients and in 24 patients with gastroenteritis. Results (mean +/- SE) were as follows: 1) control patients (n = 20), 36.2 +/- 5.7 pmol h-1 ml-1; 2) gastroenteritis (acute phase) (n = 11), 31 +/- 4.9 pmol h-1 ml-1; 3) gastroenteritis (healing phase) (...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-198501000-00008
更新日期:1985-01-01 00:00:00
abstract::We tested whether reoxygenation with 100% O(2) for 5 min after experimental asphyxia in newborn piglets was as efficient as 100% O(2) for 20 min compared with room air. Forty-one anesthetized piglets, 1-3 d old, were randomized to cerebral hypoxemia-ischemia-hypercapnia (HIH) or control (n = 5). HIH was achieved by ve...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000128978.90201.1D
更新日期:2004-07-01 00:00:00
abstract::The ontogeny of glutamine uptake by jejunal brush border membrane vesicles was studied in suckling and weanling rats and compared with the data obtained from previous studies done on adult rats in our laboratory. Glutamine uptake represented transport into the intravesicular space rather than mere binding into the mem...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199005000-00021
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Adult human airway smooth muscle (ASM) produce cytokines involved in recruitment and survival of leukocytes within airway walls. Cytokine generation by adult ASM is glucocorticoid-sensitive. Whether developing lung ASM produces cytokines in a glucocorticoid-sensitive fashion is unknown. METHODS:Cultured fet...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2015.168
更新日期:2015-12-01 00:00:00
abstract::The mechanism by which dexamethasone (DEX) inhibits neutrophil (PMN) recruitment to a site of inflammation, such as the newborn lung with bronchopulmonary dysplasia, is not completely understood. The aim of our study was to determine whether DEX inhibits neutrophil-induced neutrophil recruitment by inhibition of inter...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199910000-00008
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Angiotensin (ANG) II is involved in experimental hyperoxia-induced lung fibrosis. Angiotensin-converting enzyme-2 (ACE-2) degrades ANG II and is thus protective, but is downregulated in adult human and experimental lung fibrosis. Hyperoxia is a known cause of chronic fibrotic lung disease in neonates, but th...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2015.27
更新日期:2015-05-01 00:00:00
abstract::To examine the levels and relationship of blood pressure and insulin during puberty, blood pressure and serum insulin were measured in 3596 subjects, aged 3-18 y, whose pubertal status was graded according to the Tanner classification. The same study protocol was repeated in two follow-up surveys 3 and 6 y later for 2...
journal_title:Pediatric research
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1203/00006450-199702000-00019
更新日期:1997-02-01 00:00:00
abstract::The objective of the present study was to explore whether a free radical spin trap agent, alpha-phenyl-N-tert-butyl nitrone (PBN), influences bioenergetic failure induced in the 20-day-old fetal brain by 30 min of intrauterine ischemia in Wistar rats. Fetal brains were frozen in situ at the end of ischemia and after 1...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-200004000-00007
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Sepsis is an important cause of neonatal morbidity and mortality worldwide. Diagnosis and treatment of neonatal sepsis relies on clinical judgment and interpretation of nonspecific laboratory tests. In a prospective cohort, we measured inflammatory cytokines as a potential biomarker for neonatal sepsis. MET...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/pr.2016.267
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Bilirubin-induced neurologic dysfunction (BIND) is a spectrum of preventable neurological sequelae in jaundiced newborns. Current total plasma bilirubin (BT) concentration thresholds for phototherapy and/or exchange transfusion poorly predict BIND. METHODS:The unbound (free) bilirubin (Bf) measured at these...
journal_title:Pediatric research
pub_type: 杂志文章,评审
doi:10.1038/s41390-018-0010-3
更新日期:2018-10-01 00:00:00
abstract::To determine the effects of age, feeding regimen, and antenatal glucocorticoids on intestinal permeability, preterm infants (n = 132) were stratified by gestational age and by diet (mothers' own milk versus preterm formula), and assigned randomly to one of four feeding regimens: early-continuous, early-bolus, standard...
journal_title:Pediatric research
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1203/00006450-199810000-00009
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:There is an emerging evidence that pulmonary hypertension is associated with amino acid, carnitine, and thyroid hormone aberrations. We aimed to characterize metabolic profiles measured by the newborn screen (NBS) in infants with persistent pulmonary hypertension of the newborn (PPHN) METHODS: Nested case-co...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-018-0023-y
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Pediatric myocarditis is a rare disease with substantial mortality. Little is known regarding its prognostic factors. We hypothesize that certain comorbidities and procedural needs may increase risks of poor outcomes. This study aims to identify prognostic factors for pediatric myocarditis. METHODS:The nati...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-020-01268-7
更新日期:2020-11-18 00:00:00
abstract::Plasma antioxidant status and total radical-trapping antioxidant potential (TRAP) of children (n = 24) with cystic fibrosis (CF) were compared with those of children (n = 21) without the disease. Children with CF were found to have elevated plasma concentrations of ascorbic acid (94.6 +/- 58.2 mumol/L), with respect t...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/00006450-199303000-00008
更新日期:1993-03-01 00:00:00
abstract::Sildenafil (Viagra) has been shown to be an effective pulmonary vasodilator and is increasingly used in patients with pulmonary hypertension. Its effects on the cerebral circulation are unclear and have not yet been described. We investigated the effect of i.v. sildenafil treatment on cerebral oxygenation in 13 childr...
journal_title:Pediatric research
pub_type: 临床试验,杂志文章
doi:10.1203/01.pdr.0000198772.26417.66
更新日期:2006-03-01 00:00:00
abstract::Critically ill infants are treated with dexamethasone (Dx) and other glucocorticoids to reduce inflammation and to promote lung and cardiac function. The neonatal immune system is immature, so neonatal dendritic cells (DCs) might be especially sensitive to glucocorticoid-mediated immunosuppression. To test this, we co...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.PDR.0000157677.72136.09
更新日期:2005-07-01 00:00:00
abstract::Indomethacin is used to constrict the patent ductus arteriosus in premature infants. To clarify possible prostanoid receptor antagonists that can constrict the ductus, we studied in vivo constriction of the fetal and neonatal ductus arteriosus by AE3-208, a prostanoid EP4-receptor antagonist, in rats. Following quick ...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1203/01.pdr.0000182182.49476.24
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:The earliest onset of puberty had shifted downward, which may be due to the role of early growth and development factors in childhood. METHODS:All of 1575 Kindergarten Two (K2) children from Anhui province, China were followed up to elementary school. Girls (n = 342) with available data on AR and breast dev...
journal_title:Pediatric research
pub_type: 杂志文章
doi:10.1038/s41390-020-1001-8
更新日期:2020-06-08 00:00:00