THE PREDICTIVE VALIDITY OF RENAL ANGINA INDEX FOR SEVERE ACUTE KIDNEY INJURY IN CHILDREN WITH SEPSIS
Main Article Content
Abstract
Background: Acute kidney injury in children with sepsis requires early recognition because of its rapid progression and its association with increased mortality. The Renal Angina Index has shown potential in predicting severe acute kidney injury (stage 2-3) within the first 72 hours of admission to the intensive care unit. Objectives: To evaluate the predictive validity of the Renal Angina Index for severe acute kidney injury within the first 72 hours of the intensive care unit admission in children with sepsis. Materials and methods: A descriptive study with analytical components and longitudinal follow-up during the first 72 hours after the intensive care unit admission was conducted on 85 children aged 1 month to 16 years old who were diagnosed with sepsis and treated in the intensive care unit at Can Tho Children’s Hospital from June 2024 to February 2026. Results: The incidence of acute kidney injury within the first 72 hours of the intensive care unit admission was 27.1%, while severe acute kidney injury accounted for 16.5%. The Renal Angina Index demonstrated good discriminatory ability for severe acute kidney injury within the first 72 hours of the intensive care unit admission (AUC=0.925; 95% CI: 0.864-0.986; p<0.001). The optimal cutoff value was 9 points, yielding a sensitivity of 92.9%, a specificity of 71.8%, NPV of 98.1% and PPV of 39.4%. Calibration analysis showed good agreement between predicted and observed cases of severe acute kidney injury (p=0.226). Conclusions: The Renal Angina Index demonstrated good discriminatory ability in predicting severe acute kidney injury within the first 72 hours of the intensive care unit admission in children with sepsis. With its high negative predictive value, the Renal Angina Index may support early screening of low-risk children and guide closer renal function monitoring in high-risk patients.
Keywords
Severe acute kidney injury, sepsis, Renal Angina Index, children
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