Sanchez-Pinto and Khemani developed the Pediatric Early AKI Risk score for identifying early acute kidney injury in a critically ill child. This can help to identify a patient at risk before there is a rise in serum creatinine. The authors are from the University of Chicago and Children's Hospital Los Angeles.
Patient selection: pediatric patient in the ICU, age 1 month to 21 years
Outcome: early acute kidney injury (AKI)
Parameters:
(1) reason for ICU admission
(2) preadmission cardiac arrest
(3) BUN in mg/dL (highest value during first 12 hours in the ICU)
(4) arterial pH (lowest value during first 12 hours in the ICU)
(5) platelet count per µL (lowest value during first 12 hours in the ICU)
(6) serum total bilirubin in mg/dL (hghest value during first 12 hours in the ICU)
(7) age in years
|
Parameter
|
Findings
|
Points
|
|
reason for ICU admission
|
postoperative recovery
|
-0.95
|
|
|
other
|
0
|
|
preadmission cardiac arrest
|
no
|
0
|
|
|
yes
|
1.55
|
|
BUN
|
< 15 mg/dL
|
0
|
|
|
15 to 24 mg/dL
|
0.73
|
|
|
>= 25 mg/dL
|
2.02
|
|
arterial pH
|
< 7.21
|
1.04
|
|
|
>= 7.21
|
0
|
|
platelet count
|
< 50,000 per µL
|
1.43
|
|
|
50,000 to 94,999
|
0.95
|
|
|
95,000 to 174,999
|
0.59
|
|
|
>= 175,000 per µL
|
0
|
|
serum total bilirubin
|
< 0.6 mg/dL
|
0
|
|
|
0.6 to 17.9
|
0.34
|
|
|
>= 18 mg/dL
|
2.41
|
|
age in years
|
|
0.02 * (years)
|
X =
= SUM(points for all 7 parameters) - 4.12
probability of early acute kidney injury =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.84.
