Adverse Long-Term Outcomes following AKI in Hospitalized Children: A Meta-Analysis
Bibliographic record
Abstract
Background: Acute kidney injury (AKI) is common during pediatric hospitalizations and is associated with adverse short-term outcomes. However, long-term outcomes among survivors of pediatric AKI remain uncertain. We performed a systematic review to determine the risk of long-term outcomes following an episode of AKI. Methods: We conducted a systematic literature search in EMBASE, PubMed, and Web of Science for studies reporting adverse events at least three months following AKI defined using standardized definitions in participants aged <18 year. We excluded studies if they reported outcomes in children with obstructive lesions, renal vascular disorder (i.e HUS), or solid organ transplantations. Random effect meta-analyses were performed to calculate pooled estimates. Results: Of 12817 records identified through our initial search, 38 studies (14892 participants) were included in the final analysis. Pooled cumulative incidence of participants with CKD, mortality, proteinuria, and hypertension was 16% (95% CI: 12 to 19), 6% (3 to 8), 19% (11 to 26) and 13% (10 to 17) respectively, following an episode of AKI. Only 24 studies with follow up period ranging from 6 months to 15 years included a comparator group of patients without AKI. The odds of developing CKD was higher among children with AKI as compared to those without AKI (OR: 1.57, 95% CI: 1.05 to 2.35; Figure 1). Mortality was also higher after AKI (OR: 1.84, 95% CI: 1.28 to 2.63). There was no significant association between AKI and proteinuria (OR: 1.13, 0.63 to 2.03) or hypertension (OR: 1.27, 0.75 to 2.15) at follow up. Conclusion: Children with AKI are at a higher risk of developing long-term CKD and mortality. These findings support enhanced surveillance of kidney function after an episode of AKI, with the aim of improving long-term kidney and patient survival.Pooled odds ratio of chronic kidney disease
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.007 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".