{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:11:40Z","timestamp":1792807900187,"version":"4.5.0"},"reference-count":38,"publisher":"Elsevier BV","issue":"12","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019628","name":"BioPorto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019628","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR000077"],"award-info":[{"award-number":["UL1TR000077"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P50 DK096418-06"],"award-info":[{"award-number":["P50 DK096418-06"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007172","name":"Cincinnati Children's Hospital Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007172","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["kireports.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Kidney International Reports"],"published-print":{"date-parts":[[2023,12]]},"DOI":"10.1016\/j.ekir.2023.09.019","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T00:50:01Z","timestamp":1695343801000},"page":"2690-2700","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":79,"title":["Real-Time Acute Kidney Injury Risk Stratification\u2013Biomarker Directed Fluid Management Improves Outcomes in Critically Ill Children and Young Adults"],"prefix":"10.1016","volume":"8","author":[{"given":"Stuart L.","family":"Goldstein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli A.","family":"Krallman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjit S.","family":"Chima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajit K.","family":"Basu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakhmir","family":"Chawla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Fei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"suppl 1","key":"10.1016\/j.ekir.2023.09.019_bib1","first-page":"1","article-title":"KDIGO clinical practice guideline for acute kidney injury","volume":"2","year":"2012","journal-title":"Kidney Interational"},{"key":"10.1016\/j.ekir.2023.09.019_bib2","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1097\/PCC.0000000000000461","article-title":"Association between progression and improvement of acute kidney injury and mortality in critically ill children","volume":"16","author":"Sanchez-Pinto","year":"2015","journal-title":"Pediatr Crit Care Med"},{"key":"10.1016\/j.ekir.2023.09.019_bib3","doi-asserted-by":"crossref","first-page":"554","DOI":"10.2215\/CJN.01900214","article-title":"AKI in hospitalized children: comparing the pRIFLE, AKIN, and KDIGO definitions","volume":"10","author":"Sutherland","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib4","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa1611391","article-title":"Epidemiology of acute kidney injury in critically ill children and young adults","volume":"376","author":"Kaddourah","year":"2017","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2023.09.019_bib5","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1097\/CCM.0b013e3181cd12e1","article-title":"Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in the pediatric intensive care unit","volume":"38","author":"Schneider","year":"2010","journal-title":"Crit Care Med"},{"key":"10.1016\/j.ekir.2023.09.019_bib6","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1038\/ki.2013.349","article-title":"Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children","volume":"85","author":"Basu","year":"2014","journal-title":"Kidney Int"},{"key":"10.1016\/j.ekir.2023.09.019_bib7","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1093\/ndt\/gfv457","article-title":"Urinary biomarker incorporation into the renal angina index early in intensive care unit admission optimizes acute kidney injury prediction in critically ill children: a prospective cohort study","volume":"31","author":"Menon","year":"2016","journal-title":"Nephrol Dial Transplant"},{"key":"10.1016\/j.ekir.2023.09.019_bib8","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S2352-4642(17)30181-5","article-title":"Assessment of a renal angina index for prediction of severe acute kidney injury in critically ill children: a multicentre, multinational, prospective observational study","volume":"2","author":"Basu","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"key":"10.1016\/j.ekir.2023.09.019_bib9","first-page":"e39","article-title":"Discriminatory precision of renal angina index in predicting acute kidney injury in children; a systematic review and meta-analysis","volume":"8","author":"Abbasi","year":"2020","journal-title":"Arch Acad Emerg Med"},{"key":"10.1016\/j.ekir.2023.09.019_bib10","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1016\/j.ekir.2022.05.021","article-title":"Integration of the renal angina index and urine neutrophil gelatinase-associated lipocalin improves severe acute kidney injury prediction in critically ill children and young adults","volume":"7","author":"Goldstein","year":"2022","journal-title":"Kidney Int Rep"},{"key":"10.1016\/j.ekir.2023.09.019_bib11","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1007\/s00467-021-05368-2","article-title":"Diagnostic accuracy of renal angina index alone or in combination with biomarkers for predicting acute kidney injury in children","volume":"37","author":"Meena","year":"2022","journal-title":"Pediatr Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib12","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.29442","article-title":"Consensus-based recommendations on priority activities to address acute kidney injury in children: a modified Delphi consensus statement","volume":"5","author":"Goldstein","year":"2022","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.ekir.2023.09.019_bib13","first-page":"240","article-title":"Canadian Critical Care Trials Group, Australian and New Zealand Intensive Care Society Clinical Trials Group, et\u00a0al. Timing of initiation of renal-replacement therapy in acute kidney injury","volume":"383","author":"Investigators","year":"2020","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2023.09.019_bib14","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1056\/NEJMoa1603017","article-title":"Initiation strategies for renal-replacement therapy in the Intensive Care Unit","volume":"375","author":"Gaudry","year":"2016","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2023.09.019_bib15","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1001\/jama.2016.5828","article-title":"Effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN randomized clinical Trial","volume":"315","author":"Zarbock","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.ekir.2023.09.019_bib16","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1056\/NEJMoa1803213","article-title":"Timing of renal-replacement therapy in patients with acute kidney injury and sepsis","volume":"379","author":"Barbar","year":"2018","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ekir.2023.09.019_bib17","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1001\/jamapediatrics.2017.4540","article-title":"Association between fluid balance and outcomes in critically ill children: a systematic review and meta-analysis","volume":"172","author":"Alobaidi","year":"2018","journal-title":"JAMA Pediatr"},{"key":"10.1016\/j.ekir.2023.09.019_bib18","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1186\/s12882-021-02540-6","article-title":"Renal angina index predicts fluid overload in critically ill children: an observational cohort study","volume":"22","author":"Gorga","year":"2021","journal-title":"BMC Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib19","first-page":"435","article-title":"Early sequential risk stratification assessment to optimize fluid dosing, CRRT initiation and discontinuation in critically ill children with acute kidney injury: taking focus 2 process article","volume":"10","author":"Roy","year":"2020","journal-title":"J\u00a0Clin Trials"},{"key":"10.1016\/j.ekir.2023.09.019_bib20","doi-asserted-by":"crossref","first-page":"948","DOI":"10.2215\/CJN.05431207","article-title":"Ascertainment and epidemiology of acute kidney injury varies with definition interpretation","volume":"3","author":"Zappitelli","year":"2008","journal-title":"Clin J Am Soc Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib21","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1681\/ASN.2008030287","article-title":"New equations to estimate GFR in children with CKD","volume":"20","author":"Schwartz","year":"2009","journal-title":"J\u00a0Am Soc Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib22","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1007\/s00467-019-04294-8","article-title":"Use of height-independent baseline creatinine imputation method with renal angina index","volume":"34","author":"Roy","year":"2019","journal-title":"Pediatr Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib23","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1542\/peds.107.6.1309","article-title":"Outcome in children receiving continuous venovenous hemofiltration","volume":"107","author":"Goldstein","year":"2001","journal-title":"Pediatrics"},{"key":"10.1016\/j.ekir.2023.09.019_bib24","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1053\/j.ajkd.2009.10.048","article-title":"Fluid overload and mortality in children receiving continuous renal replacement therapy: the prospective pediatric continuous renal replacement therapy registry","volume":"55","author":"Sutherland","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"10.1016\/j.ekir.2023.09.019_bib25","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1053\/j.ajkd.2009.07.020","article-title":"NGAL Meta-analysis Investigator Group. Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis","volume":"54","author":"Haase","year":"2009","journal-title":"Am J Kidney Dis"},{"key":"10.1016\/j.ekir.2023.09.019_bib26","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1016\/j.jacc.2010.11.051","article-title":"The outcome of neutrophil gelatinase-associated lipocalin-positive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies","volume":"57","author":"Haase","year":"2011","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.ekir.2023.09.019_bib27","doi-asserted-by":"crossref","first-page":"R84","DOI":"10.1186\/cc6089","article-title":"Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study","volume":"11","author":"Zappitelli","year":"2007","journal-title":"Crit Care"},{"key":"10.1016\/j.ekir.2023.09.019_bib28","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1016\/j.jacc.2011.08.017","article-title":"Temporal relationship and predictive value of urinary acute kidney injury biomarkers after pediatric cardiopulmonary bypass","volume":"58","author":"Krawczeski","year":"2011","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.ekir.2023.09.019_bib29","doi-asserted-by":"crossref","first-page":"732","DOI":"10.2215\/CJN.03200906","article-title":"Demographic characteristics of pediatric continuous renal replacement therapy: a report of the prospective pediatric continuous renal replacement therapy registry","volume":"2","author":"Symons","year":"2007","journal-title":"Clin J Am Soc Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib30","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1097\/00003246-199605000-00004","article-title":"PRISM III: an updated Pediatric Risk of Mortality score","volume":"24","author":"Pollack","year":"1996","journal-title":"Crit Care Med"},{"key":"10.1016\/j.ekir.2023.09.019_bib31","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s12969-017-0202-0","article-title":"Effects of age and gender on reference levels of biomarkers comprising the pediatric Renal Activity Index for lupus Nephritis (p-RAIL)","volume":"15","author":"Bennett","year":"2017","journal-title":"Pediatr Rheumatol Online J"},{"key":"10.1016\/j.ekir.2023.09.019_bib32","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1681\/ASN.2017070765","article-title":"Clinical decision support for In-Hospital AKI","volume":"29","author":"Al-Jaghbeer","year":"2018","journal-title":"J\u00a0Am Soc Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib33","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1681\/ASN.2018090886","article-title":"An organizational-level program of intervention for AKI: a pragmatic stepped wedge cluster randomized trial","volume":"30","author":"Selby","year":"2019","journal-title":"J\u00a0Am Soc Nephrol"},{"key":"10.1016\/j.ekir.2023.09.019_bib34","first-page":"42","article-title":"The five \u201crights\u201d of clinical decision support","volume":"84","author":"Campbell","year":"2013","journal-title":"J\u00a0AHIMA"},{"key":"10.1016\/j.ekir.2023.09.019_bib35","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1186\/s13054-021-03725-z","article-title":"Serum renin and major adverse kidney events in critically ill patients: a multicenter prospective study","volume":"25","author":"Flannery","year":"2021","journal-title":"Crit Care"},{"key":"10.1016\/j.ekir.2023.09.019_bib36","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.15453","article-title":"Olfactomedin 4 as a novel loop of Henle-specific acute kidney injury biomarker","volume":"10","author":"Hasson","year":"2022","journal-title":"Physiol Rep"},{"key":"10.1016\/j.ekir.2023.09.019_bib37","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1016\/j.ekir.2021.04.022","article-title":"Recalibration of the renal angina index for pediatric septic shock","volume":"6","author":"Stanski","year":"2021","journal-title":"Kidney Int Rep"},{"key":"10.1016\/j.ekir.2023.09.019_bib38","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1177\/21501351211073615","article-title":"Modifying the renal angina index for predicting AKI and related adverse outcomes in pediatric heart surgery","volume":"13","author":"Gist","year":"2022","journal-title":"World J Pediatr Congenit Heart Surg"}],"container-title":["Kidney International Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2468024923015127?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2468024923015127?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T03:46:30Z","timestamp":1762832790000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2468024923015127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":38,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["S2468024923015127"],"URL":"https:\/\/doi.org\/10.1016\/j.ekir.2023.09.019","relation":{},"ISSN":["2468-0249"],"issn-type":[{"value":"2468-0249","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Real-Time Acute Kidney Injury Risk Stratification\u2013Biomarker Directed Fluid Management Improves Outcomes in Critically Ill Children and Young Adults","name":"articletitle","label":"Article Title"},{"value":"Kidney International Reports","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ekir.2023.09.019","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 International Society of Nephrology. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}