PDF(Pubmed)
Abstract：
Renal dysfunction is associated with poor outcomes in critically ill children.
To evaluate the current evidence for criteria defining renal dysfunction in critically ill children and association with adverse outcomes. To develop contemporary consensus criteria for renal dysfunction in critically ill children.
PubMed and Embase were searched from January 1992 to January 2020.
Included studies evaluated critically ill children with renal dysfunction, performance characteristics of assessment tools for renal dysfunction, and outcomes related to mortality, functional status, or organ-specific or other patient-centered outcomes. Studies with adults or premature infants (≤36 weeks\' gestational age), animal studies, reviews, case series, and studies not published in English with inability to determine eligibility criteria were excluded.
Data were extracted from included studies into a standard data extraction form by task force members.
The systematic review supported the following criteria for renal dysfunction: (1) urine output <0.5 mL/kg per hour for ≥6 hours and serum creatinine increase of 1.5 to 1.9 times baseline or ≥0.3 mg/dL, or (2) urine output <0.5 mL/kg per hour for ≥12 hours, or (3) serum creatinine increase ≥2 times baseline, or (4) estimated glomerular filtration rate <35 mL/minute/1.73 m2, or (5) initiation of renal replacement therapy, or (6) fluid overload ≥20%. Data also support criteria for persistent renal dysfunction and for high risk of renal dysfunction.
All included studies were observational and many were retrospective.
We present consensus criteria for renal dysfunction in critically ill children.
To evaluate the current evidence for criteria defining renal dysfunction in critically ill children and association with adverse outcomes. To develop contemporary consensus criteria for renal dysfunction in critically ill children.
PubMed and Embase were searched from January 1992 to January 2020.
Included studies evaluated critically ill children with renal dysfunction, performance characteristics of assessment tools for renal dysfunction, and outcomes related to mortality, functional status, or organ-specific or other patient-centered outcomes. Studies with adults or premature infants (≤36 weeks\' gestational age), animal studies, reviews, case series, and studies not published in English with inability to determine eligibility criteria were excluded.
Data were extracted from included studies into a standard data extraction form by task force members.
The systematic review supported the following criteria for renal dysfunction: (1) urine output <0.5 mL/kg per hour for ≥6 hours and serum creatinine increase of 1.5 to 1.9 times baseline or ≥0.3 mg/dL, or (2) urine output <0.5 mL/kg per hour for ≥12 hours, or (3) serum creatinine increase ≥2 times baseline, or (4) estimated glomerular filtration rate <35 mL/minute/1.73 m2, or (5) initiation of renal replacement therapy, or (6) fluid overload ≥20%. Data also support criteria for persistent renal dysfunction and for high risk of renal dysfunction.
All included studies were observational and many were retrospective.
We present consensus criteria for renal dysfunction in critically ill children.
摘要：
肾功能障碍与危重患儿预后不良相关
评估目前危重患儿肾功能不全标准的证据及其与不良结局的关系。制定危重儿童肾功能不全的当代共识标准。
从1992年1月至2020年1月搜索PubMed和Embase。
纳入的研究评估了患有肾功能不全的危重患儿，肾功能不全评估工具的性能特征，以及与死亡率相关的结果，功能状态，或器官特异性或其他以患者为中心的结果。对成人或早产儿（≤36周孕龄）的研究，动物研究,reviews,案例系列,并且不包括以英文发表的无法确定资格标准的研究.
任务组成员将纳入研究的数据提取到标准数据提取表格中。
系统评价支持以下肾功能障碍的标准：（1）尿量<0.5mL/kg每小时≥6小时，血清肌酐增加1.5至1.9倍基线或≥0.3mg/dL，或（2）尿量<0.5毫升/千克每小时≥12小时，或（3）血清肌酐增加≥2倍基线，或（4）估计的肾小球滤过率<35毫升/分钟/1.73平方米，或（5）开始肾脏替代治疗，或(6)流体过载≥20%。数据还支持持续性肾功能障碍和肾功能障碍高风险的标准。
所有纳入的研究都是观察性的，许多是回顾性的。
我们提出了危重患儿肾功能不全的共识标准。
评估目前危重患儿肾功能不全标准的证据及其与不良结局的关系。制定危重儿童肾功能不全的当代共识标准。
从1992年1月至2020年1月搜索PubMed和Embase。
纳入的研究评估了患有肾功能不全的危重患儿，肾功能不全评估工具的性能特征，以及与死亡率相关的结果，功能状态，或器官特异性或其他以患者为中心的结果。对成人或早产儿（≤36周孕龄）的研究，动物研究,reviews,案例系列,并且不包括以英文发表的无法确定资格标准的研究.
任务组成员将纳入研究的数据提取到标准数据提取表格中。
系统评价支持以下肾功能障碍的标准：（1）尿量<0.5mL/kg每小时≥6小时，血清肌酐增加1.5至1.9倍基线或≥0.3mg/dL，或（2）尿量<0.5毫升/千克每小时≥12小时，或（3）血清肌酐增加≥2倍基线，或（4）估计的肾小球滤过率<35毫升/分钟/1.73平方米，或（5）开始肾脏替代治疗，或(6)流体过载≥20%。数据还支持持续性肾功能障碍和肾功能障碍高风险的标准。
所有纳入的研究都是观察性的，许多是回顾性的。
我们提出了危重患儿肾功能不全的共识标准。
