PP459 Topic: AS17–Nephrology: Acute Kidney Injury/Renal Replacement Therapy/Electrolytes Imbalance/Other: SYSTEMATIC REVIEW AND META-ANALYSIS OF THE INCIDENCE OF CHRONIC KIDNEY DISEASE AFTER PEDIATRIC CRITICAL ILLNESS
Bibliographic record
Abstract
Aims & Objectives: Survivors of pediatric critical illnesses are at risk of significant long-term organ complications which can impact long-term health and development. Childhood chronic kidney disease (CKD) is a complication associated a diversity of long-term consequences including growth impairment, cardiovascular disease, and early death. Our objective was to conduct a systematic review of the incidence of CKD among survivors of pediatric critical illness. Methods: We searched four databases (MEDLINE, Embase, CINAHL, Cochrane) from inception to February 2023 for observational studies describing incidence of CKD among survivors after pediatric critical illness. Two reviewers independently screened citations, selected studies, extracted data, and assessed risk of bias (RoB) using the Joanna Briggs Institute Tool. Primary outcome was of incidence of CKD (at different specified thresholds, including ESRD). Meta-analysis was performed using a random-effects model. Results: Eleven studies (3114 patients) met selection criteria and reported at least one measure of CKD. No single threshold was used across all eligible studies. For each threshold, the pooled estimate of CKD incidence was 21% (CI 11-30%), 9% (CI 6-13%) and 1% (CI 0-2%) for patients with eGFR<90mL/min/1.73 m2, eGFR <60mL/min/1.73 m2 and ESRD (eGFR <15mL/min per 1.73 m2), respectively. Overall quality assessment indicated a low RoB of the included studies. Conclusions: Among pediatric critical illness survivors, an important minority of survivors developed CKD or ESRD. This study highlights the importance of diagnostic criteria for reporting, greater focus on post-critical care surveillance and follow-up to identify those with CKD, and further study to identify high-risk groups and strategies to improve outcomes. Keywords: Post-PICU outcomes, Critical care nephrology, chronic kidney disease, Follow-up, Acute kidney injury
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.027 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.016 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.014 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".