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Article

Prognostic Impact of Parameters of Metabolic Acidosis in Critically Ill Children with Acute Kidney Injury: A Retrospective Observational Analysis Using the PIC Database

1
Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan
2
Department of Nephrology, Nagoya University Hospital, Nagoya 466-8560, Japan
3
Department of Emergency and Critical Care Medicine, Komaki City Hospital, Komaki 485-8520, Japan
4
Division of Nephrology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(11), 937; https://doi.org/10.3390/diagnostics10110937
Received: 25 September 2020 / Revised: 6 November 2020 / Accepted: 9 November 2020 / Published: 11 November 2020
(This article belongs to the Special Issue Diagnosis and Management of Sepsis)
Acute kidney injury (AKI) is a major complication of sepsis that induces acid-base imbalances. While creatinine levels are the only indicator for assessing the prognosis of AKI, prognostic importance of metabolic acidosis is unknown. We conducted a retrospective observational study by analyzing a large China-based pediatric critical care database from 2010 to 2018. Participants were critically ill children with AKI admitted to intensive care units (ICUs). The study included 1505 children admitted to ICUs with AKI, including 827 males and 678 females. The median age at ICU admission was 22 months (interquartile range 7–65). After a median follow-up of 10.87 days, 4.3% (65 patients) died. After adjusting for confounding factors, hyperlactatemia, low pH, and low bicarbonate levels were independently associated with 28-day mortality (respective odds ratio: 3.06, 2.77, 2.09; p values: <0.01, <0.01, <0.01). The infection had no interaction with the three parameters. The AKI stage negatively interacted with bicarbonate and pH but not lactate. The current study shows that among children with AKI, hyperlactatemia, low pH, and hypobicarbonatemia are associated with 28-day mortality. View Full-Text
Keywords: acute kidney injury; pediatric intensive care; sepsis acute kidney injury; pediatric intensive care; sepsis
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MDPI and ACS Style

Morooka, H.; Kasugai, D.; Tanaka, A.; Ozaki, M.; Numaguchi, A.; Maruyama, S. Prognostic Impact of Parameters of Metabolic Acidosis in Critically Ill Children with Acute Kidney Injury: A Retrospective Observational Analysis Using the PIC Database. Diagnostics 2020, 10, 937. https://doi.org/10.3390/diagnostics10110937

AMA Style

Morooka H, Kasugai D, Tanaka A, Ozaki M, Numaguchi A, Maruyama S. Prognostic Impact of Parameters of Metabolic Acidosis in Critically Ill Children with Acute Kidney Injury: A Retrospective Observational Analysis Using the PIC Database. Diagnostics. 2020; 10(11):937. https://doi.org/10.3390/diagnostics10110937

Chicago/Turabian Style

Morooka, Hikaru, Daisuke Kasugai, Akihito Tanaka, Masayuki Ozaki, Atsushi Numaguchi, and Shoichi Maruyama. 2020. "Prognostic Impact of Parameters of Metabolic Acidosis in Critically Ill Children with Acute Kidney Injury: A Retrospective Observational Analysis Using the PIC Database" Diagnostics 10, no. 11: 937. https://doi.org/10.3390/diagnostics10110937

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