%0 Journal Article
%T Renal Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference.
%A Fitzgerald JC
%A Basu RK
%A Fuhrman DY
%A Gorga SM
%A Hassinger AB
%A Sanchez-Pinto LN
%A Selewski DT
%A Sutherland SM
%A Akcan-Arikan A
%A  
%J Pediatrics
%V 149
%N 1
%D 01 2022 1
%M 34970682
%F 9.703
%R 10.1542/peds.2021-052888J
%X Renal dysfunction is associated with poor outcomes in critically ill children.<BR>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.<BR>PubMed and Embase were searched from January 1992 to January 2020.<BR>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.<BR>Data were extracted from included studies into a standard data extraction form by task force members.<BR>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.<BR>All included studies were observational and many were retrospective.<BR>We present consensus criteria for renal dysfunction in critically ill children.