{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T19:30:58Z","timestamp":1792438258200,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute kidney injury (AKI) is common in the pediatric intensive care unit (ICU) and is associated with poorer clinical outcomes. There is scarce data to support an association between nutritional status and nutrient delivery in critically ill pediatric patients. Therefore, the present study aimed to identify the nutritional and clinical factors associated with the development of AKI during pediatric ICU stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study included critically ill pediatric patients aged\u2009&amp;lt;\u200915\u00a0years who were admitted to the medical and surgical pediatric ICU. Clinical, laboratory, nutritional status, nutritional therapy parameters, and AKI data were recorded. Adjusted logistic regression was applied and expressed as odds ratio (OR) and 95% confidence interval (95%CI). P-value\u2009&amp;lt;\u20090.05 was considered significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We enrolled 108 patients with a median age of 9\u00a0months (interquartile range\/IQR 2.4\u201362.5), and 43.5% developed AKI. Sepsis\/septic shock (OR 8.00; 95% CI 2.06\u201332.51, p\u2009=\u20090.003), higher severity of illness (OR 1.89; 95% CI 1.24\u20132.90, p\u2009=\u20090.003), hypoalbuminemia (OR 4.11; 95% CI 1.61\u201310.46, p\u2009=\u20090.006), edema (OR 3.42, 95% CI 1.10\u201310.67, p\u2009=\u20090.034), fluid overload (OR 3.52, 95% CI 1.56\u20137.96, p\u2009=\u20090.003), need for mechanical ventilation (OR 3.62, 95% CI 1.45\u20139.04, p\u2009=\u20090.006) and adequate protein intake (OR 0.79, 95% CI 0.63\u20131.00, p\u2009=\u20090.048) were associated with development of AKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hypoalbuminemia, need for mechanical ventilation, fluid overload, severity of illness, sepsis\/septic shock, and edema were risk factors for AKI in pediatric ICU. Furthermore, adequate protein intake is associated with AKI during pediatric ICU stay, making it important to implement nutritional assessment and nutritional therapy protocols for critically ill pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-023-01787-6","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T08:02:33Z","timestamp":1698998553000},"page":"2601-2611","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Nutritional and clinical factors associated with acute kidney injury development in critically ill children"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6825-2604","authenticated-orcid":false,"given":"Ana Luiza Cim","family":"Ribeiro de Souza","sequence":"first","affiliation":[{"name":"Joana de Gusm\u00e3o Children\u2019s Hospital, Florian\u00f3polis, Santa Catarina, Brazil 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8695-2737","authenticated-orcid":false,"given":"Alberto","family":"Piovezani","sequence":"additional","affiliation":[{"name":"Joana de Gusm\u00e3o Children\u2019s Hospital, Florian\u00f3polis, Santa Catarina, Brazil 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0492-0352","authenticated-orcid":false,"given":"Julia Carvalho","family":"Ventura","sequence":"additional","affiliation":[{"name":"Federal University of Santa Catarina, Graduate Program in Nutrition, Florian\u00f3polis, Santa Catarina, Brazil 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1534-3861","authenticated-orcid":false,"given":"Maria Goretti Moreira Guimar\u00e3es","family":"Penido","sequence":"additional","affiliation":[{"name":"Santa Casa de Belo Horizonte Hospital - Pediatric Nephrology Unit, Nephrology Center, Belo Horizonte, Minas Gerais, Brazil 3"},{"name":"Federal University of Minas Gerais , Pediatric Nephrology Unit, Belo Horizonte, Minas Gerais, Brazil 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7880-1858","authenticated-orcid":false,"given":"Nilzete Liberato","family":"Bresolin","sequence":"additional","affiliation":[{"name":"Joana de Gusm\u00e3o Children\u2019s Hospital, Florian\u00f3polis, Santa Catarina, Brazil 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4983-2911","authenticated-orcid":false,"given":"Yara Maria Franco","family":"Moreno","sequence":"additional","affiliation":[{"name":"Federal University of Santa Catarina, Graduate Program in Nutrition, Florian\u00f3polis, Santa Catarina, Brazil 2"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"issue":"4","key":"2026012110235349800_CR1","doi-asserted-by":"publisher","first-page":"568","DOI":"10.2215\/CJN.05790612","article-title":"Nutrition support among critically ill children with AKI","volume":"8","author":"Kyle","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"issue":"2","key":"2026012110235349800_CR2","doi-asserted-by":"publisher","first-page":"160","DOI":"10.5935\/0103-507X.20180034","article-title":"Reducing malnutrition in critically ill pediatric patients","volume":"30","author":"Costa","year":"2018","journal-title":"Rev Bras Ter Intensiva"},{"issue":"2","key":"2026012110235349800_CR3","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1055\/s-0035-1559806","article-title":"Enteral nutrition in the PICU: current status and ongoing challenges","volume":"4","author":"Brown","year":"2015","journal-title":"J Pediatr Intensive Care"},{"issue":"2","key":"2026012110235349800_CR4","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1590\/2175-8239-JBN-2018-0127","article-title":"Acute kidney injury epidemiology in pediatrics","volume":"41","author":"Cleto-Yamane","year":"2019","journal-title":"J Bras Nefrol"},{"issue":"4","key":"2026012110235349800_CR5","doi-asserted-by":"publisher","first-page":"429","DOI":"10.5935\/0103-507X.20180065","article-title":"Association between pediatric risk, injury, failure, loss and end stage renal disease score and mortality in a pediatric intensive care unit: a retrospective study","volume":"30","author":"Almeida","year":"2018","journal-title":"Rev Bras Ter Intensiva"},{"issue":"3","key":"2026012110235349800_CR6","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1177\/0148607112458124","article-title":"Malnutrition may worsen the prognosis of critically ill children with hyperglycemia and hypoglycemia","volume":"37","author":"Leite","year":"2013","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"2026012110235349800_CR7","first-page":"1","article-title":"KDIGO clinical practice guideline for acute kidney injury","volume":"2","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group","year":"2012","journal-title":"Kidney Inter Suppl"},{"issue":"Suppl 3","key":"2026012110235349800_CR8","doi-asserted-by":"publisher","first-page":"S135","DOI":"10.5005\/jp-journals-10071-23397","article-title":"Nutrition support in critically ill patients with AKI","volume":"24","author":"Ramakrishnan","year":"2020","journal-title":"Indian J Crit Care Med"},{"key":"2026012110235349800_CR9","doi-asserted-by":"publisher","DOI":"10.37689\/acta-ape\/2020AO0064","article-title":"Risk factors for acute renal injury in intensive clinical patients","author":"Benichel","year":"2020","journal-title":"Acta Paul Enferm"},{"issue":"2","key":"2026012110235349800_CR10","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1007\/s00134-002-1601-2","article-title":"Paediatric Index of Mortality (PIM) Study Group. 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April 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflicts of interest between the investigators and the patients, and other institutions.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study is part of a national multicenter project of pediatric ICUs with the aim of identifying nutritional and clinical variables that predict nutritional status deterioration\u2014PICU-ScREEN Study (Pediatric Intensive Care Unit Score of Risk for Early prEdiction of Nutritional deterioration). The PICU-ScREEN study was approved by the local Institutional Review Board (no 2.471.812) and the Joana de Gusm\u00e3o Children\u2019s Hospital (no 2.714.446). The present study was approved by the local Institutional Review Board of the same Hospital (no 4.443.316).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The study including human participants has been performed in the accordance with the Declaration of Helsinki and its later amendments.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"Informed consent was obtained from the parents or guardians of all the patients enrolled in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}