{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:07:04Z","timestamp":1792177624235,"version":"4.4.0"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>At type 1 diabetes mellitus (T1DM) onset, acute kidney injury (AKI) is very common. To diagnose AKI, the availability of a baseline serum creatinine (bSCr) is pivotal. However, in most hospitalized children the bSCr is unknown. We aimed to test whether the bSCr estimated on the basis of height (ebSCr) could be a reliable surrogate for AKI diagnosis compared with the measured bSCr (mbSCr). As the mbSCr, we considered the creatinine measured 14 days after T1DM onset while ebSCr (mg\/dL) = (k \u00d7 height [cm])\/120 mL\/min\/1.73 m2, where k = 0.55 for children and adolescent girls and k = 0.7 for adolescent boys. AKI was defined as serum creatinine values &gt;1.5 times the baseline creatinine. Kappa statistics and the percentage of agreement in AKI classification by ebSCr\u2013AKI versus mbSCr\u2013AKI definition methods were calculated. Bland\u2013Altman plots were used to show the agreement between the creatinine ratio (highest\/baseline creatinine; HC\/BC) calculated with mbSCr and ebSCr. The number of 163 patients with T1DM onset were included. On the basis of mbSCr, 66\/163 (40.5%) presented AKI while, on the basis of ebSCr, 50\/163 (30.7%) accomplished AKI definition. ebSCr showed good correlation with mbSCr using both the Spearman test (rho = 0.67; p &lt; 0.001) and regression analysis (r = 0.68; p &lt; 0.001). Moreover, at the Bland\u2013Altman plots, the bias of the highest\/baseline creatinine ratio calculated on the basis of the mbSCr compared to ebSCr was minimal (bias = \u22120.08 mg\/dL; 95% limits of agreement = \u22120.23\/0.39). AKI determined using ebSCr showed 90% agreement with AKI determined using mbSCr (kappa = 0.66; p &lt; 0.001). Finally, we compared the area under a receiver\u2013operating characteristic curve (AUROC) of HC\/BC ratio calculated on the basis of ebSCr with AUROC of the gold standard HC\/BC ratio calculated on the basis of mbSCr. As expected, the gold standard had an AUROC = 1.00 with a 95% confidence interval (CI) between 0.98 and 1.00, p &lt; 0.001. The HC\/BC ratio calculated on the basis of ebSCr also had significant AUROC (AUROC = 0.94; 95% CI: 0.90\u20130.97; p &lt; 0.001). The comparison of the two ROC curves showed a p &lt; 0.001. In conclusion, when mbSCr is unknown in patients with T1DM onset, the ebSCr calculated on the basis of height could be an alternative to orientate clinicians toward AKI diagnosis.<\/jats:p>","DOI":"10.3390\/children9060899","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T01:48:12Z","timestamp":1655430492000},"page":"899","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Diagnostic Performance of Height-Estimated Baseline Creatinine in Diagnosing Acute Kidney Injury in Children with Type 1 Diabetes Mellitus Onset"],"prefix":"10.3390","volume":"9","author":[{"given":"Stefano","family":"Guarino","sequence":"first","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Via Luigi De Crecchio 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-741X","authenticated-orcid":false,"given":"Giulio","family":"Rivetti","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Via Luigi De Crecchio 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5877-3757","authenticated-orcid":false,"given":"Anna","family":"Di Sessa","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Via Luigi De Crecchio 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maeva","family":"De Lucia","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Via Luigi De Crecchio 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Luigi","family":"Palma","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Via Luigi De Crecchio 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Miraglia del Giudice","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Via Luigi De Crecchio 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Polito","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Via Luigi De Crecchio 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-0170","authenticated-orcid":false,"given":"Pierluigi","family":"Marzuillo","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and of General and Specialized Surgery, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, Via Luigi De Crecchio 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2883","DOI":"10.1007\/s00467-021-05022-x","article-title":"Acute Kidney Injury in children hospitalized for community acquired pneumonia","volume":"36","author":"Marzuillo","year":"2021","journal-title":"Pediatr. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1007\/s00467-020-04834-7","article-title":"Acute Kidney Injury in children hospitalized for acute gastroenteritis: Prevalence and risk factors","volume":"36","author":"Marzuillo","year":"2021","journal-title":"Pediatr. Nephrol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Marzuillo, P., Coppola, C., Caiazzo, R., Macchini, G., Di Sessa, A., Guarino, S., Esposito, F., del Giudice, E.M., and Tipo, V. (2022). Acute Kidney Injury in Children with Acute Appendicitis. Children, 9.","DOI":"10.3390\/children9050620"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"790509","DOI":"10.3389\/fped.2021.790509","article-title":"AKI in Hospitalized Children: Poorly Documented (and Underrecognized)","volume":"9","author":"Jones","year":"2022","journal-title":"Front. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2036","DOI":"10.2215\/CJN.05190514","article-title":"Recognition and reporting of AKI in very low birth weight infants","volume":"9","author":"Carmody","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1001\/jamapediatrics.2016.1532","article-title":"Kidney Outcomes 5 Years After Pediatric Cardiac Surgery: The TRIBE-AKI Study","volume":"170","author":"Greenberg","year":"2016","journal-title":"JAMA Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1038\/ki.2011.379","article-title":"Chronic kidney disease after acute kidney injury: A systematic review and meta-analysis","volume":"81","author":"Coca","year":"2012","journal-title":"Kidney Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1038\/ki.2012.451","article-title":"Nephrologist follow-up improves all-cause mortality of severe acute kidney injury survivors","volume":"83","author":"Harel","year":"2013","journal-title":"Kidney Int."},{"key":"ref_9","first-page":"1","article-title":"Kidney disease: Improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury","volume":"2","author":"Kellum","year":"2012","journal-title":"Kidney Int. Suppl."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1007\/s00467-017-3670-z","article-title":"Evaluation of height-dependent and height-independent methods of estimating baseline serum creatinine in critically ill children","volume":"32","author":"Hessey","year":"2017","journal-title":"Pediatr. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e170020","DOI":"10.1001\/jamapediatrics.2017.0020","article-title":"Acute Kidney Injury in Children With Type 1 Diabetes Hospitalized for Diabetic Ketoacidosis","volume":"171","author":"Hursh","year":"2017","journal-title":"JAMA Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2720","DOI":"10.1210\/clinem\/dgab090","article-title":"Acute kidney injury and renal tubular damage in children with type 1 diabetes mellitus onset","volume":"106","author":"Marzuillo","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1097\/PCC.0000000000001758","article-title":"Acute Kidney Injury in Critically Ill Children Admitted to the PICU for Diabetic Ketoacidosis. A Retrospective Study","volume":"20","author":"Weissbach","year":"2019","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1097\/PCC.0000000000001926","article-title":"Methodologic Challenges in the Diagnosis of Acute Kidney Injury in Children With Diabetic Ketoacidosis","volume":"20","author":"Shein","year":"2019","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/s13312-018-1274-8","article-title":"Predictors and Outcome of Acute Kidney Injury in Children with Diabetic Ketoacidosis","volume":"55","author":"Baalaaji","year":"2018","journal-title":"Indian Pediatrics"},{"key":"ref_16","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. Am. Soc. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ibiebele, I., Algert, C.S., Bowen, J.R., and Roberts, C.L. (2018). Pediatric admissions that include intensive care: A population-based study. BMC Health Serv. Res., 18.","DOI":"10.1186\/s12913-018-3041-x"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1007\/s00467-006-0358-1","article-title":"Glomerular filtration rate measurement and estimation in chronic kidney disease","volume":"22","author":"Schwartz","year":"2007","journal-title":"Pediatr. Nephrol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1038\/s41372-018-0260-2","article-title":"Congenital solitary kidney size at birth could predict reduced eGFR levels later in life","volume":"39","author":"Marzuillo","year":"2019","journal-title":"J. Perinatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1053\/j.jrn.2018.01.001","article-title":"Anthropometric and Biochemical Determinants of Estimated Glomerular Filtration Rate in a Large Cohort of Obese Children","volume":"28","author":"Marzuillo","year":"2018","journal-title":"J. Ren. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/S0031-3955(16)36251-4","article-title":"The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents","volume":"34","author":"Schwartz","year":"1987","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"141","DOI":"10.11613\/BM.2015.015","article-title":"Understanding Bland Altman analysis","volume":"25","author":"Giavarina","year":"2015","journal-title":"Biochem. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1148\/radiology.148.3.6878708","article-title":"A method of comparing the areas under receiver operating characteristic curves derived from the same cases","volume":"148","author":"Hanley","year":"1983","journal-title":"Radiology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s00467-007-0583-2","article-title":"Diabetic nephropathy in children and adolescents","volume":"23","year":"2008","journal-title":"Pediatr. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1001\/jamapediatrics.2021.5038","article-title":"Association of Acute Kidney Injury during Diabetic Ketoacidosis with Risk of Microalbuminuria in Children with Type 1 Diabetes","volume":"176","author":"Huang","year":"2022","journal-title":"JAMA Pediatr."},{"key":"ref_27","unstructured":"Devarajan, P. (2019). Acute Kidney Injury in Children: Clinical Features, Etiology, Evaluation, and Diagnosis, UpToDate."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1038\/nrneph.2017.9","article-title":"Acute kidney injury: Still misunderstood and misdiagnosed","volume":"13","author":"Devarajan","year":"2017","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1001\/jamapediatrics.2017.0009","article-title":"Acute kidney injury in children admitted with diabetic ketoacidosis: Finding the sweet spot of fluid management","volume":"171","author":"Laskin","year":"2017","journal-title":"JAMA Pediatr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"E793","DOI":"10.1056\/NEJMoa1716816","article-title":"Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis","volume":"378","author":"Kuppermann","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1007\/s00467-011-2081-9","article-title":"A simple height-independent equation for estimating glomerular filtration rate in children","volume":"27","author":"Pottel","year":"2012","journal-title":"Pediatr. Nephrol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.1365-2796.2000.00768.x","article-title":"The influence of ketoacids on plasma creatinine assays in diabetic ketoacidosis","volume":"248","author":"Kemperman","year":"2000","journal-title":"J. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/MOP.0b013e328343f4dd","article-title":"Biomarkers for the Early Detection of Acute Kidney Injury","volume":"23","author":"Devarajan","year":"2011","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1681\/ASN.2016060666","article-title":"Glomerular hyperfiltration in diabetes: Mechanisms, clinical significance, and treatment","volume":"28","author":"Tonneijck","year":"2017","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"528","DOI":"10.2215\/CJN.05731108","article-title":"Misapplications of Commonly Used Kidney Equations: Renal Physiology in Practice","volume":"4","author":"Nguyen","year":"2009","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_36","unstructured":"(2022, April 04). CDC Surveillance System: Laboratory Reporting Using IDMS-Traceable Creatinine Calibration, Available online: https:\/\/nccd.cdc.gov\/ckd\/detail.aspx?Qnum=Q223."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/6\/899\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:32:43Z","timestamp":1760139163000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/6\/899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,16]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["children9060899"],"URL":"https:\/\/doi.org\/10.3390\/children9060899","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,16]]}}}