Growth after pediatric and neonatal acute kidney injury: a meta-analysis
Bibliographic record
Abstract
BACKGROUND: Acute kidney injury (AKI) occurs commonly in critically ill children. The impact of AKI on pediatric growth outcomes has been sparsely described. OBJECTIVE: To compare growth in children with a history of AKI compared to those without AKI. We hypothesized that children with AKI would have worse growth compared to those without AKI. DATA SOURCES: A convenience sample of existing prospective and retrospective cohorts of children with AKI who had already collected or were able to collect data on growth parameters before and after an episode of AKI. STUDY ELIGIBILITY CRITERIA: There are < 5 studies in the published literature on growth in children with AKI. These investigators were contacted, and additional studies were added by contacting primary investigators of studies of childhood AKI in which data on growth parameters was able to be collected. PARTICIPANTS AND INTERVENTIONS: Children from existing cohorts evaluating AKI (exposure) during childhood. Each included cohort had previously received local IRB approval per institutional guidelines. As our study was a meta-analysis and only used cohort-level data, no IRB approval was required for this report. STUDY APPRAISAL AND SYNTHESIS METHODS: statistic was used to define variability due to between-cohort heterogeneity. RESULTS: We included 3,586 children from 17 existing cohorts of AKI in various populations, including infants, children with cardiac disease, solid organ transplant and critically ill children without cardiac disease with follow-up from 12 months to 11 years after AKI. At most distant follow-up, those with AKI had lower length z-score than those without AKI (mean difference -0.37 [95%CI -0.52, -0.22, p < 0.001]) and lower weight z-score (mean difference of -0.29 [95%CI -0.43, -0.15, p < 0.001]). This difference was most striking in infants, as those with AKI had impaired growth (both length z-score and weight z-score) after AKI compared to those without AKI. LIMITATIONS: The analysis included only a convenience sample of observational cohorts of children, study selection could have been biased, and we did not evaluate the relationship between decreased kidney function (e.g., chronic kidney disease) after AKI in these cohorts and its relationship to poor growth. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: This meta-analysis found that children with AKI have impaired growth after AKI. These findings were most striking in infants. We suggest focusing on growth outcomes in both clinical care and research investigating the impacts of AKI. SYSTEMATIC REVIEW REGISTRATION NUMBER: NA.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.005 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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; both teacher heads agree on what is shown here.
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".