{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:53:35Z","timestamp":1791266015969,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010342","name":"Gillbergska stiftelsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010342","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative acute kidney injury (AKI) is associated with substantial morbidity and mortality. Reliable estimates of AKI after surgery in children are lacking. To address this gap, we aimed to synthesize the available evidence on the incidence of AKI after pediatric noncardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Cochrane and Web of Science for studies reporting the incidence of AKI, defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, within 7 postoperative days. Observational studies and clinical trials including patients aged &lt;\u200918\u2009years were eligible. The review followed the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010seven studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921\u2009908) were included. Considerable heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200998.7%) and likely overrepresentation of clinically distinct high\u2010risk populations limited the interpretability of a single overall pooled incidence estimate. The incidence was 22.3% (95% CI, 11.2\u201339.3) after neonatal surgery, 30.1% (95% CI, 21.4\u201340.6) after pediatric liver transplantation, and 9.2% (95% CI, 3.3\u201323.6) in mixed pediatric surgical populations. The certainty of evidence was rated low to very low. In mixed pediatric surgical populations, AKI incidence increased from 2.4% in American Society of Anesthesiologists (ASA) class 1\u20132 to 7.5% in ASA 3 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 18.9% in ASA 4\u20135 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and decreased from 9.8% at 0\u20132\u2009years to 4.0% at 12\u201318\u2009years (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The reported incidence of postoperative AKI in children undergoing noncardiac surgery remains uncertain due to substantial heterogeneity and overrepresentation of high\u2010risk populations. AKI incidence was high in neonates and liver transplant recipients and was associated with younger age and higher ASA class, although data were limited. Further prospective studies in broader pediatric surgical populations are needed to better assess the risk of postoperative AKI in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO registration no.: CRD42024518832<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pan.70284","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:20:50Z","timestamp":1787059250000},"page":"1387-1399","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Postoperative Acute Kidney Injury After Noncardiac Surgery: A Systematic Review and 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