Clinical Report: Identifying Risk Factors and Creating a Nomogram for Anticipating Severe Acute Kidney Injury in Pediatric Sepsis
Overview
This study developed and validated a nomogram to predict severe acute kidney injury (AKI) in children with sepsis. The nomogram demonstrated moderate discrimination and identified key independent predictors of severe AKI.
Background
Sepsis is a critical condition in pediatric intensive care units, with a significant proportion of affected children developing acute kidney injury (AKI). Severe AKI is associated with increased mortality and long-term complications.
Data Highlights
Parameter
Value
Severe AKI Incidence
23.1%
Mortality Rate (Severe AKI)
31.1%
Mortality Rate (No AKI)
12.5%
AUC (Logistic Regression Model)
0.782
AUC (Nomogram)
0.761
Sensitivity (Nomogram)
62.70%
Specificity (Nomogram)
80.80%
Key Findings
Severe AKI occurred in 23.1% of pediatric sepsis patients.
The mortality rate in the severe AKI group was 31.1%, significantly higher than 12.5% in the no clinically significant AKI group.
Independent predictors of severe AKI included elevated phosphate, decreased albumin, elevated uric acid, and reduced antithrombin III.
The logistic regression model achieved an AUC of 0.782, indicating moderate discrimination.
The nomogram achieved an AUC of 0.761, with a sensitivity of 62.70% and specificity of 80.80%.
Clinical Implications
The nomogram developed in this study can assist clinicians in identifying children at high risk for severe AKI due to sepsis.
Conclusion
The study identified key risk factors for severe AKI in pediatric sepsis and developed a nomogram with moderate predictive capability.
