Severe acute kidney injury in critically ill children: Epidemiology and prognostic factors

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Touza Pol, C. Rey Galán, J.A. Medina Villanueva, P. Martinez-Camblor, J. López-Herce" "autores" => array:6 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Touza Pol" "email" => array:1 [ 0 => "tousrula@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Rey Galán" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "J.A." "apellidos" => "Medina Villanueva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "P." 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"apellidos" => "López-Herce" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] 5 => array:2 [ "colaborador" => "en representación del Grupo de Estudio del Fallo Renal Agudo de la Sociedad Española de Cuidados Intensivos Pediátricos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "fn1" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Unidad de Cuidados Intensivos Pediátricos, Hospital Madrid Torrelodones, Torrelodones, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Oficina de Investigación Biosanitaria de Asturias (OIB), Chile" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Universidad Autónoma de Chile, Chile" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Red de Salud Maternoinfantil y del Desarrollo, Madrid, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Daño renal agudo grave en niños críticos: epidemiología y factores pronósticos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 772 "Ancho" => 1623 "Tamanyo" => 87637 ] ] "descripcion" => array:1 [ "en" => "Useful algorithm to determine the risk of mortality or the need for dialysis in critically ill children with AKI." ] ] ] "textoCompleto" => "IntroductionAcute kidney injury (AKI) is a severe complication in Paediatric Intensive Care Units (PICU), with a mortality rate of between 30 and 44%.<a class="elsevierStyleCrossRefs" href="#bib0005">1–5</a>Over the past few years, studies have been performed using one of 2 standardised definitions of AKI: the modified paediatric RIFLE criteria (pRIFLE)<a class="elsevierStyleCrossRef" href="#bib0030">6</a> or the classification system Acute Kidney Injury Network (AKIN).<a class="elsevierStyleCrossRef" href="#bib0035">7</a> These studies have shown the different impact of AKI on critically ill children, due to variations in severity and in the inclusion criteria of study populations. However, all have found that AKI is associated with a longer hospital stay and higher mortality.<a class="elsevierStyleCrossRefs" href="#bib0040">8,9</a>Since AKI in critically ill children has high morbidity and mortality, it is necessary to investigate prognostic markers, which will detect patients who may benefit from prompt treatment.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> The objective of this study is to describe the epidemiological characteristics of AKI in Spanish PICUs and to identify risk factors that will predict mortality and the need for renal replacement therapy after discharge from the PICU.Patients and methodsA multi-centre prospective observational study was conducted in 19 Spanish PICUs for one year (15 October, 2002–15 October, 2003), taking as reference a previous pilot study conducted in 4 units.<a class="elsevierStyleCrossRef" href="#bib0020">4</a>The study included children aged between 7 days and 16 years, presenting acute alteration of kidney function, excluding premature new-born babies. Among children with chronic kidney failure and acute worsening of kidney function, AKI is defined as a 25% serum creatinine increase above baseline level in a maximum period of 72h. Re-admissions of patients with a new episode of AKI are considered independent cases. AKI was defined as serum creatinine higher than 2 standard deviations (SD) above the normal value for the patient's age.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> Patients were classified retrospectively according to the changes in creatinine values based on pRIFLE criteria<a class="elsevierStyleCrossRef" href="#bib0030">6</a>: 23.3% were classified with “Injury” status, and 73.5% as “Failure”, with 3.2% at “Risk”. On PICU discharge, 10% had “Loss” status and 6.7% were at “End stage”.For all patients, the age, weight, sex, Paediatric Risk of Mortality Score (PRISM II),<a class="elsevierStyleCrossRef" href="#bib0060">12</a> cause of AKI, type of AKI (oliguric or preserved diuresis), clearance techniques, medical complications, organ dysfunction,<a class="elsevierStyleCrossRef" href="#bib0065">13</a> serial analytical data (on PICU admission, on AKI diagnosis, at 24h of diagnosis, at the beginning of dialysis, at the end of the latter, and at PICU discharge), were recorded, as well as the maximum change in urea, creatinine, creatinine clearance (calculated by means of the Schwartz equation), glucose, acid-base balance, ions, proteins, uric acid, lactate and haemogram, need for dialysis on PICU discharge, mortality, and causes of the latter. The maximum change in creatinine and urea, and the minimum platelet value refer to the maximum and minimum values reached during admission, respectively.Continuous variables were described by means of mean±standard deviations or by medians and ranges. Categorical variables were described by means of absolute and relative frequencies. The comparisons of continuous and categorical variables were made by means of the Mann–Whitney and the chi-square tests, respectively. Multivariate logistic regression analyses were used to develop prognostic criteria. Variables were introduced into these models, based on the likelihood ratio criterion. To minimise data loss, variables that did not fit the model were excluded. The area under the curve (AUC) “Receiver Operating Characteristic” (ROC) was used to measure the prognostic capability of the models. To minimise the effect of missing values, the “general bootstrap algorithm” was used for the comparison with the AUC.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> Significant differences were defined as those with a “p” lower than 0.05. The data was processed by means of the free software R.3.1 (<a id="intr0005" class="elsevierStyleInterRef" href="http://www.r-project.org/">www.r-project.org</a>).ResultsThere were 7119 admissions, with 143 cases (2%) of AKI, during the study period. Four cases were excluded due to absence of data. The mean age±SD was 51.8±57.4 months. In 49.6% of cases, patients were under two years (34,8% under 12 months). Oligoanuria accounted for 66.7% of all cases. The main causes were postoperative complications (25.2%): congenital heart disease (33 cases), pulmonary transplant (2 cases), and liver transplant (one case), infectious processes (24.5%), 97% of which involved sepsis, and renal pathology (20.3%), most of which (7.7%) involved haemolytic uraemic syndrome. Other triggering pathologies included problems with the heart (9.1%), digestion (4.9%), breathing (2.8%) and haematological disorders (1.4%).All cases involved medical complications, with thrombocytopenia in 84.5%, organ failure during treatment in 86%, in addition to kidney failure (mean organ failure±SD: 2.8±1.8). The most frequent were respiratory (72.5%) and cardiovascular (67.1%) failures, with 55% of patients presenting 3 or more organ failures, 37% 4 or more, and 20% 5 or more, with a mortality of 55%, 60% and 65%, respectively.Mortality during admission to the PICU was 32.4%, with the mortality estimated by PRISM II at 20.9%.<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the clinical and analytical characteristics of the total population, including survivors and non-survivors, and patients with or without need for dialysis on discharge from PICU, as well as mortality and need for dialysis on discharge for the 3 largest aetiological subgroups. All non-survivors and all patients needing dialysis on discharge presented some organ dysfunction, as well as a higher number of organ failures. The platelet count at AKI diagnosis and peak platelet levels were significantly lower in both non-surviivors and patients needing dialysis after discharge. The presence of thrombocytopenia (platelets<150,000/mm3) was associated with higher mortality.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Risk factors requiring dialysis on discharge from the Paediatric Intensive Care UnitIn 86 patients (60.1%) renal replacement therapy was needed, with peritoneal dialysis (45%) and continuous venovenous extrarenal clearance techniques (44%) being the most widely used. Among non-survivors, 60% were receiving dialysis at the time of death, while 15.1% of survivors required dialysis on discharge from the PICU.The capacity of analytical parameters to predict the need of dialysis on discharge from the PICU expressed as area under ROC curve with its respective cutoff points is shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. The minimum platelet count was the variable with the best predictive capability.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>In the study of multivariate logistic regression, only the minimum platelet and creatinine clearance values remained in the final model. For every additional 1000 platelets/mm3, the risk of dialysis on discharge decreased (risk per 0.876) or, put differently, each 1000platelet/mm3 decrease multiplied the risk by 1.141 (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). An equation was obtained which can predict the need for dialysis on discharge:<elsevierMultimedia ident="eq0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the AUCs with their respective cutoff points.<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>Risk factors to predict mortalityMost deaths (89%) were caused by multi-organ failure, and the mean number of organs that failed among non-survivors was 4.1±1.1.The capacity of analytical parameters to predict mortality is shown in <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>. The value of uric acid on admission was the most relevant variable.<elsevierMultimedia ident="tbl0025"></elsevierMultimedia>In the multivariate logistic regression study, the minimum platelet value, the maximum creatinine value, and the weight remained in the final model (<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>). Both the platelet and creatinine values acted as factors protecting against mortality, so that for each additional 1mg/dl of creatinine the risk of death was reduced by 0.309, and for each additional 1000platelets/mm3 the risk was reduced by 0.949.<elsevierMultimedia ident="tbl0030"></elsevierMultimedia>The equation obtained to predict mortality during admission was:<elsevierMultimedia ident="eq0010"></elsevierMultimedia>Weight is a minor factor in the equation, but a more significant factor in the univariate analysis. In the equation, greater weight slightly increases the risk of death, whereas in the univariate analysis the opposite occurred. The cutoff point for this equation is negative, with a value of −3.17, so that values below this point predict survival and values above this point predict mortality. <a class="elsevierStyleCrossRef" href="#tbl0035">Table 7</a> shows the AUCs with their respective cutoff points.<elsevierMultimedia ident="tbl0035"></elsevierMultimedia>As the equations created might not be of practical use in clinical practice, a simple algorithm was devised to indicate which patients have a high risk of mortality or need for dialysis on discharge from the PICU (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>DiscussionThe incidence of AKI in childhood is still unclear, since each study has included different types of patients and used different diagnostic criteria.<a class="elsevierStyleCrossRef" href="#bib0075">15</a> AKI incidence is greater among newborns. Between 3.4 and 24% develop AKI.<a class="elsevierStyleCrossRefs" href="#bib0080">16,17</a> A prospective study with critical paediatric patients, including non-premature newborns older than 3 days, reported an AKI incidence of 4.5%, which is more than twice that of our study, probably due to the inclusion of patients younger than one week of age.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>The epidemiology of AKI has changed due to therapeutic advances and a growing trend to present secondary to other pathologies.<a class="elsevierStyleCrossRefs" href="#bib0050">10,18–21</a> In our study, the most frequent aetiologies were heart surgery, septic processes and nephrologic causes.Patients undergoing additional surgery are at high risk of AKI.<a class="elsevierStyleCrossRefs" href="#bib0110">22–24</a> Severe sepsis and septic shock are risk factors for AKI. However, studies report a lower percentage of AKI secondary to sepsis than that found in our study.<a class="elsevierStyleCrossRefs" href="#bib0050">10,18,25</a>With regard to nephrologic causes, our results show that the haemolytic uraemic syndrome, even though infrequent in Spain,<a class="elsevierStyleCrossRef" href="#bib0130">26</a> is a major cause of AKI.<a class="elsevierStyleCrossRefs" href="#bib0125">25,27,28</a>AKI significantly increases the morbidity and mortality of critically ill patients.<a class="elsevierStyleCrossRefs" href="#bib0050">10,15</a> Paediatric AKI is almost always present in the context of organ failure.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> In our study, 86% of patients presented some organ failure other than kidney failure during treatment, with an average of almost 3 dysfunctions per patient.A large proportion of children presenting AKI recover kidney function during their stay in the PICU. In our study, 15% of survivors required dialysis on discharge from the PICU, although the development of kidney function in the long term was not analysed. We have not found any studies analysing the risk factors for need for dialysis on discharge from the PICU, and only some studies in adults have investigated the predictive factors for kidney recovery among critically ill patients with AKI.<a class="elsevierStyleCrossRef" href="#bib0145">29</a> Our results show that thrombocytopenia was a good predictor of poor evolution of AKI, whereas a major decrease in creatinine clearance was not an independent predictor, but was valuable as part of an equation in which both variables were present. From the data from our sample, 100% of patients with values above the cutoff point of the equation will not need dialysis on discharge from the PICU (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).Mortality was 32.4%, similar to the 27% and 32% reported in other prospective studies in critically ill children.<a class="elsevierStyleCrossRefs" href="#bib0010">2,10</a> These values are lower than those reported in adult Intensive Care Units.<a class="elsevierStyleCrossRefs" href="#bib0150">30,31</a> In other paediatric studies, most non-survivors were found to present a severe underlying condition<a class="elsevierStyleCrossRefs" href="#bib0160">32,33</a> and a relationship between multi-organ failure and mortality,<a class="elsevierStyleCrossRefs" href="#bib0095">19,30</a> which is consistent with our findings.A finding of interest is that the probability of death calculated with PRISM II undervalued the actual risk of death. This scenario has already been described in several studies.<a class="elsevierStyleCrossRefs" href="#bib0170">34,35</a> A more recent prospective work showed that clinical severity scales (PRISM, PIM and PELOD) undervalued mortality in children treated with continuous techniques. Of these 3, PRISM had the highest predictive value.Analysing the capacity of analytical parameters to predict mortality showed that serum uric acid at admission was the most relevant parameter in the univariate analysis. However, it did not remain a mortality risk in the multivariate analysis, leading us to believe that its predictive capacity depends on other factors.In the multivariate study, the minimum value of platelets, the maximum change in creatinine, and patient weight remained in the final model, although the latter was of minor importance. The equation was highly predictive of mortality, with a sensitivity of 97% and a specificity of 67%. Our results show that thrombocytopenia was a good predictor of mortality, whereas higher values of creatinine were associated with a greater survival rate. The association of higher creatinine values with a better prognosis reinforces the theory that AKI mortality among children is not related to kidney failure itself, but mainly to the triggering cause and the existence of multi-organ failure.<a class="elsevierStyleCrossRefs" href="#bib0135">27,28,33</a> Thus, low mortality rates are observed in isolated AKI without organ failure where the creatinine value may be very high. Conversely, mortality increases when AKI, even with not too high creatinine values, occurs in the context of multiple organ failure.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> This fact coincides with the results of studies among critical children treated with extrarenal clearance techniques.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> In support of this hypothesis, in our study mortality is lower in cases of renal aetiology (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). In contrast, other studies in critically ill children have found a relationship between increased creatinine and higher severity on the RIFLE scale, based on serum creatinine values, with mortality.<a class="elsevierStyleCrossRefs" href="#bib0045">9,36</a>In our sample, thrombocytopenia was the most important risk factor for poor prognosis. Most studies have analysed the impact on prognosis of values below 150,000–100,000platelets/mm3. Others stress the diagnostic relevance of the relative decrease of platelets.<a class="elsevierStyleCrossRef" href="#bib0185">37</a> Thrombocytopenia has been described as the main risk factor for the development of AKI among children.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>There are several limitations to our study: the definition used for AKI did not originally include the pRIFLE criteria, since at the time the study was designed the criteria had not yet been published. We have retrospectively classified our patients following the pRIFLE criteria, based on the maximum values of blood creatinine. Most patients were classified in the Failure group, although the criteria based on oliguria or anuria was not considered.The second limitation is that a significant period has elapsed between data collection and processing and publication. This leads us to consider the study conclusions with more caution when applying them to the current situation. Recently, the publication of studies where data collection, as in our case, occurred 10 years before publication has been defended.<a class="elsevierStyleCrossRef" href="#bib0190">38</a> Factors such as difficulties involved in gathering and analysing data in multi-centre studies, changes in professional, teaching and investigative responsibilities of authors, or failure to agree on the text of the article justify the delay in publication. Investigators have a responsibility to publish the results of studies quickly, but when external circumstances delay publication, we must make the necessary efforts for data to be finally published.The third limitation is the improvement which has taken place in creatinine measurement techniques, resulting in lower values than some years ago, and, consequently, the calculation formulas of creatinine clearance have changed.<a class="elsevierStyleCrossRefs" href="#bib0195">39,40</a>Lastly, our study has only analysed the evolution of AKI during the stay at the PICU. It is important to conduct studies analysing whether a recovery or deterioration of kidney function occurs after discharge from the PICU.Our research constitutes one of the biggest prospective studies conducted so far on AKI in critically ill children with the participation of a significant number of Spanish PICUs, so its results are representative of the reality in our country at the time of the study. This data is a good starting point to undertake comparative studies over time on AKI in critically ill children.To conclude, our results confirm the existence of high morbidity and mortality in critically ill children with AKI. Platelet count and creatinine clearance values were good predictors of the need for dialysis on discharge from the PICU. Platelet count and serum creatinine were mortality markers in paediatric AKI.Conflict of interestThe authors state there is no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres597259" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec611970" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres597258" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec611969" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and methods" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Risk factors requiring dialysis on discharge from the Paediatric Intensive Care Unit" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Risk factors to predict mortality" ] ] ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-10-05" "fechaAceptado" => "2015-01-21" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec611970" "palabras" => array:5 [ 0 => "Acute kidney injury" 1 => "Paediatric intensive care units" 2 => "Outcome" 3 => "Mortality" 4 => "Renal replacement therapy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec611969" "palabras" => array:5 [ 0 => "Daño renal agudo" 1 => "Unidades de Cuidados Intensivos Pediátricos" 2 => "Pronóstico" 3 => "Mortalidad" 4 => "Depuración extrarrenal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionAcute kidney injury (AKI) is a severe complication in critically ill children. The aim of the study was to describe the characteristics of AKI, as well as to analyse the prognostic factors for mortality and renal replacement therapy (RRT) in children admitted to Paediatric Intensive Care Units (PICUs) in Spain. Patients and methodsProspective observational multicentre study in children from 7 days to 16 years old who were admitted to a PICU. A univariate and multivariate logistic regression analysis of the risk factors for mortality and renal replacement therapy at PICU discharge were performed. ResultsA total of 139 cases of AKI were analysed. RRT was necessary in 60.1% of cases. Mortality rate was 32.6%. At PICU discharge, RRT was necessary in 15% of survivors. Thrombopenia and low creatinine clearance values were prognostic markers of RRT at PICU discharge. High values of platelets, serum creatinine and weight were associated with higher survival. ConclusionsCritically ill children with AKI had a high mortality and morbidity rate. Platelet values and creatinine clearance are markers of RRT at PICU discharge, whereas number of platelets, serum creatinine and weight were associated with mortality." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónEl daño renal agudo (DRA) es una complicación grave en niños críticos. El objetivo de este estudio fue describir las características de esta patología en las Unidades de Cuidados Intensivos Pediátricos (UCIP) españolas e identificar factores de riesgo asociados con la mortalidad y la necesidad de depuración extrarrenal al alta. Pacientes y métodosEstudio prospectivo observacional multicéntrico que incluyó niños de 7 días a 16 años de edad con DRA ingresados en UCIP. Se realizó un estudio univariante y multivariante de los factores de riesgo asociados con la mortalidad y necesidad de depuración extrarrenal al alta. ResultadosSe analizaron 139 casos de DRA. En el 60,1% de los casos fue necesaria la utilización de alguna técnica de depuración. La mortalidad durante el ingreso fue del 32,4% y el 15,1% de los supervivientes necesitaban diálisis al alta de la UCIP. En el estudio de regresión logística multivariante la trombocitopenia y los valores bajos de aclaramiento de creatinina fueron factores pronósticos que predijeron la necesidad de diálisis al alta. Ajustando por peso, las cifras elevadas de plaquetas y creatinina se relacionaron con una mayor supervivencia. ConclusionesLos niños críticamente enfermos con DRA presentan una morbimortalidad elevada. La cifra de plaquetas y el aclaramiento de creatinina son marcadores de necesidad de diálisis al alta de la UCIP y la cifra de plaquetas, la creatinina sérica y el peso, marcadores de supervivencia." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Pol PT, Galán CR, Villanueva JAM, Martinez-Camblor P, López-Herce J, en representación del Grupo de Estudio del Fallo Renal Agudo de la Sociedad Española de Cuidados Intensivos Pediátricos. Daño renal agudo grave en niños críticos: epidemiología y factores pronósticos. An Pediatr (Barc). 2015;83:367–375." ] 1 => array:3 [ "etiqueta" => "1" "nota" => "Los miembros del Grupo de Estudio del Fallo Renal Agudo de la Sociedad Española de Cuidados Intensivos Pediátricos se presentan en el <a class="elsevierStyleCrossRef" href="#sec0040">Appendix A</a>." "identificador" => "fn1" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:3 [ "apendice" => "Grupo de Estudio del Fallo Renal Agudo de la Sociedad Española de Cuidados Intensivos Pediátricos: María Carmen Martínez Ferriz, Montserrat Antón Gamero, Jesús López-Herce Cid, Cinta Téllez González, Yolanda López Fernández, José Alberto Medina Villanueva, María del Pilar Azcón González de Aguilar, José Luis Vázquez Martínez, Joseba Landa Maya, Federico Martinón Torres, Martí Pons Odena, Miguel Herrera, Amelia Martínez de Azagra, José Domingo López Castilla, Juan A. García Hernández, Manuel González Ripoll, Antonio Gómez Calzado, Esther Ocete Hita, Angel Hernández Borges, Teresa Gili Bigata." "etiqueta" => "Appendix A" "identificador" => "sec0040" ] ] ] ] "multimedia" => array:10 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 772 "Ancho" => 1623 "Tamanyo" => 87637 ] ] "descripcion" => array:1 [ "en" => "Useful algorithm to determine the risk of mortality or the need for dialysis in critically ill children with AKI." ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "AKI: acute kidney injury; (P25; P75): 25 percentile; 75 percentile; PICU: Paediatric Intensive Care Unit." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total casesMedian (P25; P75) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-survivorsMedian (P25; P75) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SurvivorsMedian (P25; P75) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dialysis upon discharge from PICUMedian (P25; P75) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No dialysis upon discharge from PICUMedian (P25; P75) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">139 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">79 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age (months) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 (5; 87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 (2; 83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 (7.5; 92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 (14.5; 146) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32.5 (6.7; 81.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.2 (5.2; 24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9.3 (4.1; 27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 (8; 22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.5 (11; 40.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14.5 (7.6; 22) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Creatinine on admission to PICU (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.1 (0.6; 2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.6 (0.5; 1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.3 (0.7; 2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.3 (1.2; 5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.1 (0.7; 2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Creatinine on AKI diagnosis (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.5 (1; 2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.1 (0.9; 1.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.7 (1.2; 2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.7 (1.8; 6.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.5 (1.1; 2.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Creatinine clearance on admission to PICU (ml/min/1.73 m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 (18.8; 56.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">45 (28.9; 90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33 (17; 52) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.5 (13.9; 20.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36.2 (22.3; 54.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Creatinine clearance at AKI diagnosis (ml/min/1.73 m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28.3 (14.8; 40.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30.6 (26; 38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 (14; 41.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24.1 (11; 33.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26 (14.4; 41.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Platelets at AKI diagnosis (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">108,000 (49,500; 248,000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64,000<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> (39,500; 181,000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">132,000 (77,000; 261,000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">49,000<a class="elsevierStyleCrossRef" href="#tblfn0010">**</a> (22,750; 259,500) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">148,500 (84,500; 265,000) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum platelet count (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34,000 (15,000; 58,500) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.000<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> (12,800; 39,000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40,000 (18,750; 86,500) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15,000<a class="elsevierStyleCrossRef" href="#tblfn0010">**</a> (10,000; 32,000) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">52,000 (25,300; 88,500) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Thrombocytopenia (<150,000/mm3) (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">84.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">95.7<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">84.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">81 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Likelihood of mortality according to PRISM (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 (6; 20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23 (5; 54.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.6 (1.4; 20.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.8 (1.4; 30.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.5 (1.6; 21) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Organ failure (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">74.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of organ failures \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (1; 4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> (3; 5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (1; 3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4<a class="elsevierStyleCrossRef" href="#tblfn0010">**</a> (2; 5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (0; 3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Postoperative aetiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Infectious aetiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Renal aetiology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2<a class="elsevierStyleCrossRef" href="#tblfn0015">***</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab976841.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "p<0.05 in the comparison between non-survivors and survivors." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "**" "nota" => "p<0.05 in the comparison between dialysis and no dialysis on discharge from the PICU." ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "***" "nota" => "p<0.05 in the comparison with mortality due to other aetiologies." ] ] ] "descripcion" => array:1 [ "en" => "Clinical and analytical characteristics of all patients: non-survivors, survivors, those requiring dialysis after PICU discharge and those that did not." ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Sp: specificity; AKI: acute kidney injury; CI: confidence interval; S: sensitivity." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Area under curve \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff point \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sp \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maximum creatinine change (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.707 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.591–0.823 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.731 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.637 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maximum urea change (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.700 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.572–0.829 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">190 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.542 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.850 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum value of creatinine clearance (ml/min/1.73 m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.708 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.566–0.849 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.020 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.786 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.699 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Platelets at AKI diagnosis (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.696 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.547–0.846 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.636 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.852 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Platelets at 24h after AKI diagnosis (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.703 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.559–0.848 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56,500 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.600 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.821 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum platelet count (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.849 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.763–0.935 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34,350 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.857 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.690 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab976837.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Capacity of analytical parameters to predict need for dialysis at discharge, according to the univariate model." ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "CI: confidence interval; OR: odds ratio." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum platelet count (thousands/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.876 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.794–0.967 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.008 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum value of creatinine clearance (ml/min/1.73 m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.928 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.858–1.004 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.062 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab976839.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Multivariate analysis of need for dialysis at discharge from PICU." ] ] 4 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Sp: specificity; Equation: 0.075×minimum creatinine clearance (ml/min/1.73m2)+0.132×minimum platelets (thousands/mm3); CI: confidence interval, S: sensitivity." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Area under curve \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff point \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sp \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum platelet count (thousands/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.891 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.796–0.986 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34,350 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.857 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.690 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maximum change in creatinine clearance (ml/min/1.73m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.643 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.474–0.812 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.157 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17,070 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.786 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.699 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Equation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.914 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.832–0.996 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5730 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.715 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab976840.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Capacity of maximum change in platelets and creatinine clearance and the study equation to predict need for dialysis at discharge, according to the multivariate model." ] ] 5 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Sp: specificity; AKI: acute kidney injury; CI: confidence interval; S: sensitivity; PICU: Paediatric Intensive Care Unit." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Area under curve \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff point \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sp \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Creatinine on admission to PICU (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.734 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.645–0.823 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.511 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.829 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maximum creatinine value (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.646 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.555–0.737 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.954 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.377 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Urea on admission to PICU (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.658 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.554–0.762 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.004 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">72.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.820 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0467 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum pH value \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.715 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.597–0.832 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.852 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.544 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Bicarbonate on admission to PICU (mEq/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.616 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.512–0.720 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.033 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.667 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.596 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Phosphorus on admission to PICU (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.718 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.535–0.901 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.026 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.583 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.853 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Uric acid on admission to PICU (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.938 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.866–1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.844 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Protein on admission to PICU (g/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.662 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.559–0.765 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.004 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.625 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.671 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Leukocytes on admission to PICU (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.649 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.547–0.752 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6715 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.454 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.803 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum leukocyte level (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.686 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.515–0.857 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.036 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1600 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.388 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.973 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Platelets on AKI diagnosis (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.671 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.573–0.771 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">81,000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.622 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.736 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Platelets at 24h after AKI diagnosis (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.726 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.625–0.826 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62,500 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.714 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.741 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum platelet count (n/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.719 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.621–0.816 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47,500 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.872 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.464 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab976838.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Capacity of analytical parameters to predict mortality, according to the univariate model." ] ] 6 => array:7 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "CI: confidence interval; OR: odds ratio." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maximum creatinine value (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.309 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.143–0.665 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum platelet value (thousands of platelets/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.949 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.921–0.979 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.041 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000–1.084 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.052 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab976842.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Multivariate analysis for mortality. Lower in creatinine and platelet values are associated with a higher risk of mortality." ] ] 7 => array:7 [ "identificador" => "tbl0035" "etiqueta" => "Table 7" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Sp: specificity; Equation: −0.9×maximum creatinine (mg/dl)−0.04×minimum platelets (thousands/mm3)+0.025×weight (kg); CI: confidence interval; S: sensitivity." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Area under curve \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff point \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sp \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maximum creatinine value (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.646 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.555–0.737 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.954 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.376 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimum platelet count (thousands/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.719 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.621–0.816 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.897 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.435 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.580 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.474–0.687 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.128 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.511 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.718 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Equation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.834 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.755–0.911 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−3.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.973 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.687 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab976843.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Capacity of maximum change in platelets and creatinine clearance, weight, and the study equation to predict mortality, according to the multivariate model. Lower creatinine and platelet values are associated with higher risk of mortality." ] ] 8 => array:5 [ "identificador" => "eq0005" "tipo" => "MULTIMEDIAFORMULA" "mostrarFloat" => false "mostrarDisplay" => true "Formula" => array:5 [ "Matematica" => "0.075×minimum creatinine clearance (ml/min/1.73 m2)+0.132×minimum platelets (thousands/mm3)" "Fichero" => "STRIPIN_si1.jpeg" "Tamanyo" => 6676 "Alto" => 44 "Ancho" => 372 ] ] 9 => array:5 [ "identificador" => "eq0010" "tipo" => "MULTIMEDIAFORMULA" "mostrarFloat" => false "mostrarDisplay" => true "Formula" => array:5 [ "Matematica" => "−0.9×maximum creatinine (mg/dl)−0.04× minimum platelets (thousands/mm3)+0.025×weight (kg)" "Fichero" => "STRIPIN_si2.jpeg" "Tamanyo" => 6304 "Alto" => 69 "Ancho" => 296 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors of acute renal failure in critically ill children. 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Original Article

Severe acute kidney injury in critically ill children: Epidemiology and prognostic factors

Daño renal agudo grave en niños críticos: epidemiología y factores pronósticos

P. Touza Pola,

Corresponding author

tousrula@yahoo.es

Corresponding author.

, C. Rey Galánb,c, J.A. Medina Villanuevab, P. Martinez-Camblord,e, J. López-Hercef, en representación del Grupo de Estudio del Fallo Renal Agudo de la Sociedad Española de Cuidados Intensivos Pediátricos 1

a Unidad de Cuidados Intensivos Pediátricos, Hospital Madrid Torrelodones, Torrelodones, Madrid, Spain

b Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain

c Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain

d Oficina de Investigación Biosanitaria de Asturias (OIB), Chile

e Universidad Autónoma de Chile, Chile

f Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón, Red de Salud Maternoinfantil y del Desarrollo, Madrid, Spain

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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Useful algorithm to determine the risk of mortality or the need for dialysis in critically ill children with AKI&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Acute kidney injury &#40;AKI&#41; is a severe complication in Paediatric Intensive Care Units &#40;PICU&#41;&#44; with a mortality rate of between 30 and 44&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Over the past few years&#44; studies have been performed using one of 2 standardised definitions of AKI&#58; the modified paediatric RIFLE criteria &#40;pRIFLE&#41;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> or the classification system Acute Kidney Injury Network &#40;AKIN&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> These studies have shown the different impact of AKI on critically ill children&#44; due to variations in severity and in the inclusion criteria of study populations&#46; However&#44; all have found that AKI is associated with a longer hospital stay and higher mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Since AKI in critically ill children has high morbidity and mortality&#44; it is necessary to investigate prognostic markers&#44; which will detect patients who may benefit from prompt treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> The objective of this study is to describe the epidemiological characteristics of AKI in Spanish PICUs and to identify risk factors that will predict mortality and the need for renal replacement therapy after discharge from the PICU&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A multi-centre prospective observational study was conducted in 19 Spanish PICUs for one year &#40;15 October&#44; 2002&#8211;15 October&#44; 2003&#41;&#44; taking as reference a previous pilot study conducted in 4 units&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The study included children aged between 7 days and 16 years&#44; presenting acute alteration of kidney function&#44; excluding premature new-born babies&#46; Among children with chronic kidney failure and acute worsening of kidney function&#44; AKI is defined as a 25&#37; serum creatinine increase above baseline level in a maximum period of 72<span class="elsevierStyleHsp" style=""></span>h&#46; Re-admissions of patients with a new episode of AKI are considered independent cases&#46; AKI was defined as serum creatinine higher than 2 standard deviations &#40;SD&#41; above the normal value for the patient&#39;s age&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Patients were classified retrospectively according to the changes in creatinine values based on pRIFLE criteria<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#58; 23&#46;3&#37; were classified with &#8220;Injury&#8221; status&#44; and 73&#46;5&#37; as &#8220;Failure&#8221;&#44; with 3&#46;2&#37; at &#8220;Risk&#8221;&#46; On PICU discharge&#44; 10&#37; had &#8220;Loss&#8221; status and 6&#46;7&#37; were at &#8220;End stage&#8221;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">For all patients&#44; the age&#44; weight&#44; sex&#44; Paediatric Risk of Mortality Score &#40;PRISM II&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> cause of AKI&#44; type of AKI &#40;oliguric or preserved diuresis&#41;&#44; clearance techniques&#44; medical complications&#44; organ dysfunction&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> serial analytical data &#40;on PICU admission&#44; on AKI diagnosis&#44; at 24<span class="elsevierStyleHsp" style=""></span>h of diagnosis&#44; at the beginning of dialysis&#44; at the end of the latter&#44; and at PICU discharge&#41;&#44; were recorded&#44; as well as the maximum change in urea&#44; creatinine&#44; creatinine clearance &#40;calculated by means of the Schwartz equation&#41;&#44; glucose&#44; acid-base balance&#44; ions&#44; proteins&#44; uric acid&#44; lactate and haemogram&#44; need for dialysis on PICU discharge&#44; mortality&#44; and causes of the latter&#46; The maximum change in creatinine and urea&#44; and the minimum platelet value refer to the maximum and minimum values reached during admission&#44; respectively&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Continuous variables were described by means of mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviations or by medians and ranges&#46; Categorical variables were described by means of absolute and relative frequencies&#46; The comparisons of continuous and categorical variables were made by means of the Mann&#8211;Whitney and the chi-square tests&#44; respectively&#46; Multivariate logistic regression analyses were used to develop prognostic criteria&#46; Variables were introduced into these models&#44; based on the likelihood ratio criterion&#46; To minimise data loss&#44; variables that did not fit the model were excluded&#46; The area under the curve &#40;AUC&#41; &#8220;Receiver Operating Characteristic&#8221; &#40;ROC&#41; was used to measure the prognostic capability of the models&#46; To minimise the effect of missing values&#44; the &#8220;general bootstrap algorithm&#8221; was used for the comparison with the AUC&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Significant differences were defined as those with a &#8220;<span class="elsevierStyleItalic">p</span>&#8221; lower than 0&#46;05&#46; The data was processed by means of the free software R&#46;3&#46;1 &#40;<a id="intr0005" class="elsevierStyleInterRef" href="http://www.r-project.org/">www&#46;r-project&#46;org</a>&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">There were 7119 admissions&#44; with 143 cases &#40;2&#37;&#41; of AKI&#44; during the study period&#46; Four cases were excluded due to absence of data&#46; The mean age<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD was 51&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>57&#46;4 months&#46; In 49&#46;6&#37; of cases&#44; patients were under two years &#40;34&#44;8&#37; under 12 months&#41;&#46; Oligoanuria accounted for 66&#46;7&#37; of all cases&#46; The main causes were postoperative complications &#40;25&#46;2&#37;&#41;&#58; congenital heart disease &#40;33 cases&#41;&#44; pulmonary transplant &#40;2 cases&#41;&#44; and liver transplant &#40;one case&#41;&#44; infectious processes &#40;24&#46;5&#37;&#41;&#44; 97&#37; of which involved sepsis&#44; and renal pathology &#40;20&#46;3&#37;&#41;&#44; most of which &#40;7&#46;7&#37;&#41; involved haemolytic uraemic syndrome&#46; Other triggering pathologies included problems with the heart &#40;9&#46;1&#37;&#41;&#44; digestion &#40;4&#46;9&#37;&#41;&#44; breathing &#40;2&#46;8&#37;&#41; and haematological disorders &#40;1&#46;4&#37;&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">All cases involved medical complications&#44; with thrombocytopenia in 84&#46;5&#37;&#44; organ failure during treatment in 86&#37;&#44; in addition to kidney failure &#40;mean organ failure<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#58; 2&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;8&#41;&#46; The most frequent were respiratory &#40;72&#46;5&#37;&#41; and cardiovascular &#40;67&#46;1&#37;&#41; failures&#44; with 55&#37; of patients presenting 3 or more organ failures&#44; 37&#37; 4 or more&#44; and 20&#37; 5 or more&#44; with a mortality of 55&#37;&#44; 60&#37; and 65&#37;&#44; respectively&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Mortality during admission to the PICU was 32&#46;4&#37;&#44; with the mortality estimated by PRISM II at 20&#46;9&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the clinical and analytical characteristics of the total population&#44; including survivors and non-survivors&#44; and patients with or without need for dialysis on discharge from PICU&#44; as well as mortality and need for dialysis on discharge for the 3 largest aetiological subgroups&#46; All non-survivors and all patients needing dialysis on discharge presented some organ dysfunction&#44; as well as a higher number of organ failures&#46; The platelet count at AKI diagnosis and peak platelet levels were significantly lower in both non-surviivors and patients needing dialysis after discharge&#46; The presence of thrombocytopenia &#40;platelets<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>150&#44;000&#47;mm<span class="elsevierStyleSup">3</span>&#41; was associated with higher mortality&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Risk factors requiring dialysis on discharge from the Paediatric Intensive Care Unit</span><p id="par0060" class="elsevierStylePara elsevierViewall">In 86 patients &#40;60&#46;1&#37;&#41; renal replacement therapy was needed&#44; with peritoneal dialysis &#40;45&#37;&#41; and continuous venovenous extrarenal clearance techniques &#40;44&#37;&#41; being the most widely used&#46; Among non-survivors&#44; 60&#37; were receiving dialysis at the time of death&#44; while 15&#46;1&#37; of survivors required dialysis on discharge from the PICU&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The capacity of analytical parameters to predict the need of dialysis on discharge from the PICU expressed as area under ROC curve with its respective cutoff points is shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The minimum platelet count was the variable with the best predictive capability&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">In the study of multivariate logistic regression&#44; only the minimum platelet and creatinine clearance values remained in the final model&#46; For every additional 1000 platelets&#47;mm<span class="elsevierStyleSup">3</span>&#44; the risk of dialysis on discharge decreased &#40;risk per 0&#46;876&#41; or&#44; put differently&#44; each 1000<span class="elsevierStyleHsp" style=""></span>platelet&#47;mm<span class="elsevierStyleSup">3</span> decrease multiplied the risk by 1&#46;141 &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; An equation was obtained which can predict the need for dialysis on discharge&#58;<elsevierMultimedia ident="eq0005"></elsevierMultimedia></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the AUCs with their respective cutoff points&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Risk factors to predict mortality</span><p id="par0080" class="elsevierStylePara elsevierViewall">Most deaths &#40;89&#37;&#41; were caused by multi-organ failure&#44; and the mean number of organs that failed among non-survivors was 4&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;1&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The capacity of analytical parameters to predict mortality is shown in <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#46; The value of uric acid on admission was the most relevant variable&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">In the multivariate logistic regression study&#44; the minimum platelet value&#44; the maximum creatinine value&#44; and the weight remained in the final model &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>&#41;&#46; Both the platelet and creatinine values acted as factors protecting against mortality&#44; so that for each additional 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl of creatinine the risk of death was reduced by 0&#46;309&#44; and for each additional 1000<span class="elsevierStyleHsp" style=""></span>platelets&#47;mm<span class="elsevierStyleSup">3</span> the risk was reduced by 0&#46;949&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">The equation obtained to predict mortality during admission was&#58;<elsevierMultimedia ident="eq0010"></elsevierMultimedia></p><p id="par0100" class="elsevierStylePara elsevierViewall">Weight is a minor factor in the equation&#44; but a more significant factor in the univariate analysis&#46; In the equation&#44; greater weight slightly increases the risk of death&#44; whereas in the univariate analysis the opposite occurred&#46; The cutoff point for this equation is negative&#44; with a value of &#8722;3&#46;17&#44; so that values below this point predict survival and values above this point predict mortality&#46; <a class="elsevierStyleCrossRef" href="#tbl0035">Table 7</a> shows the AUCs with their respective cutoff points&#46;</p><elsevierMultimedia ident="tbl0035"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">As the equations created might not be of practical use in clinical practice&#44; a simple algorithm was devised to indicate which patients have a high risk of mortality or need for dialysis on discharge from the PICU &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">The incidence of AKI in childhood is still unclear&#44; since each study has included different types of patients and used different diagnostic criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> AKI incidence is greater among newborns&#46; Between 3&#46;4 and 24&#37; develop AKI&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a> A prospective study with critical paediatric patients&#44; including non-premature newborns older than 3 days&#44; reported an AKI incidence of 4&#46;5&#37;&#44; which is more than twice that of our study&#44; probably due to the inclusion of patients younger than one week of age&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The epidemiology of AKI has changed due to therapeutic advances and a growing trend to present secondary to other pathologies&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;18&#8211;21</span></a> In our study&#44; the most frequent aetiologies were heart surgery&#44; septic processes and nephrologic causes&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Patients undergoing additional surgery are at high risk of AKI&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#8211;24</span></a> Severe sepsis and septic shock are risk factors for AKI&#46; However&#44; studies report a lower percentage of AKI secondary to sepsis than that found in our study&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;18&#44;25</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">With regard to nephrologic causes&#44; our results show that the haemolytic uraemic syndrome&#44; even though infrequent in Spain&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> is a major cause of AKI&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;27&#44;28</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">AKI significantly increases the morbidity and mortality of critically ill patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;15</span></a> Paediatric AKI is almost always present in the context of organ failure&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> In our study&#44; 86&#37; of patients presented some organ failure other than kidney failure during treatment&#44; with an average of almost 3 dysfunctions per patient&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">A large proportion of children presenting AKI recover kidney function during their stay in the PICU&#46; In our study&#44; 15&#37; of survivors required dialysis on discharge from the PICU&#44; although the development of kidney function in the long term was not analysed&#46; We have not found any studies analysing the risk factors for need for dialysis on discharge from the PICU&#44; and only some studies in adults have investigated the predictive factors for kidney recovery among critically ill patients with AKI&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Our results show that thrombocytopenia was a good predictor of poor evolution of AKI&#44; whereas a major decrease in creatinine clearance was not an independent predictor&#44; but was valuable as part of an equation in which both variables were present&#46; From the data from our sample&#44; 100&#37; of patients with values above the cutoff point of the equation will not need dialysis on discharge from the PICU &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Mortality was 32&#46;4&#37;&#44; similar to the 27&#37; and 32&#37; reported in other prospective studies in critically ill children&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;10</span></a> These values are lower than those reported in adult Intensive Care Units&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">30&#44;31</span></a> In other paediatric studies&#44; most non-survivors were found to present a severe underlying condition<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">32&#44;33</span></a> and a relationship between multi-organ failure and mortality&#44;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;30</span></a> which is consistent with our findings&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">A finding of interest is that the probability of death calculated with PRISM II undervalued the actual risk of death&#46; This scenario has already been described in several studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">34&#44;35</span></a> A more recent prospective work showed that clinical severity scales &#40;PRISM&#44; PIM and PELOD&#41; undervalued mortality in children treated with continuous techniques&#46; Of these 3&#44; PRISM had the highest predictive value&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Analysing the capacity of analytical parameters to predict mortality showed that serum uric acid at admission was the most relevant parameter in the univariate analysis&#46; However&#44; it did not remain a mortality risk in the multivariate analysis&#44; leading us to believe that its predictive capacity depends on other factors&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">In the multivariate study&#44; the minimum value of platelets&#44; the maximum change in creatinine&#44; and patient weight remained in the final model&#44; although the latter was of minor importance&#46; The equation was highly predictive of mortality&#44; with a sensitivity of 97&#37; and a specificity of 67&#37;&#46; Our results show that thrombocytopenia was a good predictor of mortality&#44; whereas higher values of creatinine were associated with a greater survival rate&#46; The association of higher creatinine values with a better prognosis reinforces the theory that AKI mortality among children is not related to kidney failure itself&#44; but mainly to the triggering cause and the existence of multi-organ failure&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#44;28&#44;33</span></a> Thus&#44; low mortality rates are observed in isolated AKI without organ failure where the creatinine value may be very high&#46; Conversely&#44; mortality increases when AKI&#44; even with not too high creatinine values&#44; occurs in the context of multiple organ failure&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> This fact coincides with the results of studies among critical children treated with extrarenal clearance techniques&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In support of this hypothesis&#44; in our study mortality is lower in cases of renal aetiology &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; In contrast&#44; other studies in critically ill children have found a relationship between increased creatinine and higher severity on the RIFLE scale&#44; based on serum creatinine values&#44; with mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;36</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">In our sample&#44; thrombocytopenia was the most important risk factor for poor prognosis&#46; Most studies have analysed the impact on prognosis of values below 150&#44;000&#8211;100&#44;000<span class="elsevierStyleHsp" style=""></span>platelets&#47;mm<span class="elsevierStyleSup">3</span>&#46; Others stress the diagnostic relevance of the relative decrease of platelets&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> Thrombocytopenia has been described as the main risk factor for the development of AKI among children&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">There are several limitations to our study&#58; the definition used for AKI did not originally include the pRIFLE criteria&#44; since at the time the study was designed the criteria had not yet been published&#46; We have retrospectively classified our patients following the pRIFLE criteria&#44; based on the maximum values of blood creatinine&#46; Most patients were classified in the Failure group&#44; although the criteria based on oliguria or anuria was not considered&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The second limitation is that a significant period has elapsed between data collection and processing and publication&#46; This leads us to consider the study conclusions with more caution when applying them to the current situation&#46; Recently&#44; the publication of studies where data collection&#44; as in our case&#44; occurred 10 years before publication has been defended&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a> Factors such as difficulties involved in gathering and analysing data in multi-centre studies&#44; changes in professional&#44; teaching and investigative responsibilities of authors&#44; or failure to agree on the text of the article justify the delay in publication&#46; Investigators have a responsibility to publish the results of studies quickly&#44; but when external circumstances delay publication&#44; we must make the necessary efforts for data to be finally published&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">The third limitation is the improvement which has taken place in creatinine measurement techniques&#44; resulting in lower values than some years ago&#44; and&#44; consequently&#44; the calculation formulas of creatinine clearance have changed&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#44;40</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">Lastly&#44; our study has only analysed the evolution of AKI during the stay at the PICU&#46; It is important to conduct studies analysing whether a recovery or deterioration of kidney function occurs after discharge from the PICU&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Our research constitutes one of the biggest prospective studies conducted so far on AKI in critically ill children with the participation of a significant number of Spanish PICUs&#44; so its results are representative of the reality in our country at the time of the study&#46; This data is a good starting point to undertake comparative studies over time on AKI in critically ill children&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">To conclude&#44; our results confirm the existence of high morbidity and mortality in critically ill children with AKI&#46; Platelet count and creatinine clearance values were good predictors of the need for dialysis on discharge from the PICU&#46; Platelet count and serum creatinine were mortality markers in paediatric AKI&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflict of interest</span><p id="par0195" class="elsevierStylePara elsevierViewall">The authors state there is no conflict of interest&#46;</p></span></span>"
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            1 => "Paediatric intensive care units"
            2 => "Outcome"
            3 => "Mortality"
            4 => "Renal replacement therapy"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec611969"
          "palabras" => array:5 [
            0 => "Da&#241;o renal agudo"
            1 => "Unidades de Cuidados Intensivos Pedi&#225;tricos"
            2 => "Pron&#243;stico"
            3 => "Mortalidad"
            4 => "Depuraci&#243;n extrarrenal"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Acute kidney injury &#40;AKI&#41; is a severe complication in critically ill children&#46; The aim of the study was to describe the characteristics of AKI&#44; as well as to analyse the prognostic factors for mortality and renal replacement therapy &#40;RRT&#41; in children admitted to Paediatric Intensive Care Units &#40;PICUs&#41; in Spain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prospective observational multicentre study in children from 7 days to 16 years old who were admitted to a PICU&#46; A univariate and multivariate logistic regression analysis of the risk factors for mortality and renal replacement therapy at PICU discharge were performed&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 139 cases of AKI were analysed&#46; RRT was necessary in 60&#46;1&#37; of cases&#46; Mortality rate was 32&#46;6&#37;&#46; At PICU discharge&#44; RRT was necessary in 15&#37; of survivors&#46; Thrombopenia and low creatinine clearance values were prognostic markers of RRT at PICU discharge&#46; High values of platelets&#44; serum creatinine and weight were associated with higher survival&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Critically ill children with AKI had a high mortality and morbidity rate&#46; Platelet values and creatinine clearance are markers of RRT at PICU discharge&#44; whereas number of platelets&#44; serum creatinine and weight were associated with mortality&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El da&#241;o renal agudo &#40;DRA&#41; es una complicaci&#243;n grave en ni&#241;os cr&#237;ticos&#46; El objetivo de este estudio fue describir las caracter&#237;sticas de esta patolog&#237;a en las Unidades de Cuidados Intensivos Pedi&#225;tricos &#40;UCIP&#41; espa&#241;olas e identificar factores de riesgo asociados con la mortalidad y la necesidad de depuraci&#243;n extrarrenal al alta&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo observacional multic&#233;ntrico que incluy&#243; ni&#241;os de 7 d&#237;as a 16 a&#241;os de edad con DRA ingresados en UCIP&#46; Se realiz&#243; un estudio univariante y multivariante de los factores de riesgo asociados con la mortalidad y necesidad de depuraci&#243;n extrarrenal al alta&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se analizaron 139 casos de DRA&#46; En el 60&#44;1&#37; de los casos fue necesaria la utilizaci&#243;n de alguna t&#233;cnica de depuraci&#243;n&#46; La mortalidad durante el ingreso fue del 32&#44;4&#37; y el 15&#44;1&#37; de los supervivientes necesitaban di&#225;lisis al alta de la UCIP&#46; En el estudio de regresi&#243;n log&#237;stica multivariante la trombocitopenia y los valores bajos de aclaramiento de creatinina fueron factores pron&#243;sticos que predijeron la necesidad de di&#225;lisis al alta&#46; Ajustando por peso&#44; las cifras elevadas de plaquetas y creatinina se relacionaron con una mayor supervivencia&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los ni&#241;os cr&#237;ticamente enfermos con DRA presentan una morbimortalidad elevada&#46; La cifra de plaquetas y el aclaramiento de creatinina son marcadores de necesidad de di&#225;lisis al alta de la UCIP y la cifra de plaquetas&#44; la creatinina s&#233;rica y el peso&#44; marcadores de supervivencia&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as&#58; Pol PT&#44; Gal&#225;n CR&#44; Villanueva JAM&#44; Martinez-Camblor P&#44; L&#243;pez-Herce J&#44; en representaci&#243;n del Grupo de Estudio del Fallo Renal Agudo de la Sociedad Espa&#241;ola de Cuidados Intensivos Pedi&#225;tricos&#46; Da&#241;o renal agudo grave en ni&#241;os cr&#237;ticos&#58; epidemiolog&#237;a y factores pron&#243;sticos&#46; An Pediatr &#40;Barc&#41;&#46; 2015&#59;83&#58;367&#8211;375&#46;</p>"
      ]
      1 => array:3 [
        "etiqueta" => "1"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Los miembros del Grupo de Estudio del Fallo Renal Agudo de la Sociedad Espa&#241;ola de Cuidados Intensivos Pedi&#225;tricos se presentan en el <a class="elsevierStyleCrossRef" href="#sec0040">Appendix A</a>&#46;</p>"
        "identificador" => "fn1"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:3 [
            "apendice" => "<p id="par0205" class="elsevierStylePara elsevierViewall">Grupo de Estudio del Fallo Renal Agudo de la Sociedad Espa&#241;ola de Cuidados Intensivos Pedi&#225;tricos&#58; Mar&#237;a Carmen Mart&#237;nez Ferriz&#44; Montserrat Ant&#243;n Gamero&#44; Jes&#250;s L&#243;pez-Herce Cid&#44; Cinta T&#233;llez Gonz&#225;lez&#44; Yolanda L&#243;pez Fern&#225;ndez&#44; Jos&#233; Alberto Medina Villanueva&#44; Mar&#237;a del Pilar Azc&#243;n Gonz&#225;lez de Aguilar&#44; Jos&#233; Luis V&#225;zquez Mart&#237;nez&#44; Joseba Landa Maya&#44; Federico Martin&#243;n Torres&#44; Mart&#237; Pons Odena&#44; Miguel Herrera&#44; Amelia Mart&#237;nez de Azagra&#44; Jos&#233; Domingo L&#243;pez Castilla&#44; Juan A&#46; Garc&#237;a Hern&#225;ndez&#44; Manuel Gonz&#225;lez Ripoll&#44; Antonio G&#243;mez Calzado&#44; Esther Ocete Hita&#44; Angel Hern&#225;ndez Borges&#44; Teresa Gili Bigata&#46;</p>"
            "etiqueta" => "Appendix A"
            "identificador" => "sec0040"
          ]
        ]
      ]
    ]
    "multimedia" => array:10 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 772
            "Ancho" => 1623
            "Tamanyo" => 87637
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Useful algorithm to determine the risk of mortality or the need for dialysis in critically ill children with AKI&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">AKI&#58; acute kidney injury&#59; &#40;P25&#59; P75&#41;&#58; 25 percentile&#59; 75 percentile&#59; PICU&#58; Paediatric Intensive Care Unit&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total casesMedian &#40;P25&#59; P75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non-survivorsMedian &#40;P25&#59; P75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SurvivorsMedian &#40;P25&#59; P75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dialysis upon discharge from PICUMedian &#40;P25&#59; P75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No dialysis upon discharge from PICUMedian &#40;P25&#59; P75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Number of patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">139&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Age &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;5&#59; 87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;2&#59; 83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;7&#46;5&#59; 92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;14&#46;5&#59; 146&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#46;5 &#40;6&#46;7&#59; 81&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Weight &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;2 &#40;5&#46;2&#59; 24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#46;3 &#40;4&#46;1&#59; 27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;8&#59; 22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;5 &#40;11&#59; 40&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#46;5 &#40;7&#46;6&#59; 22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Creatinine on admission to PICU &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;1 &#40;0&#46;6&#59; 2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;6 &#40;0&#46;5&#59; 1&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;3 &#40;0&#46;7&#59; 2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;3 &#40;1&#46;2&#59; 5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;1 &#40;0&#46;7&#59; 2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Creatinine on AKI diagnosis &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;5 &#40;1&#59; 2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;1 &#40;0&#46;9&#59; 1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;7 &#40;1&#46;2&#59; 2&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;7 &#40;1&#46;8&#59; 6&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;5 &#40;1&#46;1&#59; 2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Creatinine clearance on admission to PICU &#40;ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;18&#46;8&#59; 56&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;28&#46;9&#59; 90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33 &#40;17&#59; 52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;5 &#40;13&#46;9&#59; 20&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&#46;2 &#40;22&#46;3&#59; 54&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Creatinine clearance at AKI diagnosis &#40;ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;3 &#40;14&#46;8&#59; 40&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30&#46;6 &#40;26&#59; 38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;14&#59; 41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#46;1 &#40;11&#59; 33&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;14&#46;4&#59; 41&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Platelets at AKI diagnosis &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">108&#44;000 &#40;49&#44;500&#59; 248&#44;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#44;000<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a> &#40;39&#44;500&#59; 181&#44;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">132&#44;000 &#40;77&#44;000&#59; 261&#44;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#44;000<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a> &#40;22&#44;750&#59; 259&#44;500&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">148&#44;500 &#40;84&#44;500&#59; 265&#44;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum platelet count &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#44;000 &#40;15&#44;000&#59; 58&#44;500&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;000<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a> &#40;12&#44;800&#59; 39&#44;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#44;000 &#40;18&#44;750&#59; 86&#44;500&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#44;000<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a> &#40;10&#44;000&#59; 32&#44;000&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&#44;000 &#40;25&#44;300&#59; 88&#44;500&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Thrombocytopenia &#40;&#60;150&#44;000&#47;mm<span class="elsevierStyleSup">3</span>&#41; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">95&#46;7<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Likelihood of mortality according to PRISM &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;6&#59; 20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;5&#59; 54&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;6 &#40;1&#46;4&#59; 20&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;8 &#40;1&#46;4&#59; 30&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8&#46;5 &#40;1&#46;6&#59; 21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Organ failure &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">74&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Number of organ failures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;1&#59; 4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a> &#40;3&#59; 5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#59; 3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a> &#40;2&#59; 5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#59; 3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Postoperative aetiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Infectious aetiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Renal aetiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab976841.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 in the comparison between non-survivors and survivors&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "&#42;&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 in the comparison between dialysis and no dialysis on discharge from the PICU&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "&#42;&#42;&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 in the comparison with mortality due to other aetiologies&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Clinical and analytical characteristics of all patients&#58; non-survivors&#44; survivors&#44; those requiring dialysis after PICU discharge and those that did not&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Sp&#58; specificity&#59; AKI&#58; acute kidney injury&#59; CI&#58; confidence interval&#59; S&#58; sensitivity&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Area under curve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff point&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">S</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Maximum creatinine change &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;707&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;591&#8211;0&#46;823&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;731&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;637&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Maximum urea change &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;572&#8211;0&#46;829&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">190&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;542&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;850&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum value of creatinine clearance &#40;ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;708&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;566&#8211;0&#46;849&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;786&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;699&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Platelets at AKI diagnosis &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;696&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;547&#8211;0&#46;846&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;636&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;852&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Platelets at 24<span class="elsevierStyleHsp" style=""></span>h after AKI diagnosis &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;703&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;559&#8211;0&#46;848&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#44;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;821&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum platelet count &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;849&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;763&#8211;0&#46;935&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34&#44;350&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;857&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab976837.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Capacity of analytical parameters to predict need for dialysis at discharge&#44; according to the univariate model&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">CI&#58; confidence interval&#59; OR&#58; odds ratio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum platelet count &#40;thousands&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;876&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;794&#8211;0&#46;967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum value of creatinine clearance &#40;ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;928&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;858&#8211;1&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;062&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab976839.png"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Multivariate analysis of need for dialysis at discharge from PICU&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Sp&#58; specificity&#59; Equation&#58; 0&#46;075<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>minimum creatinine clearance &#40;ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>0&#46;132<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>minimum platelets &#40;thousands&#47;mm<span class="elsevierStyleSup">3</span>&#41;&#59; CI&#58; confidence interval&#44; S&#58; sensitivity&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Area under curve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff point&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">S</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum platelet count &#40;thousands&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;891&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;796&#8211;0&#46;986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#44;350&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;857&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Maximum change in creatinine clearance &#40;ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;643&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;474&#8211;0&#46;812&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;070&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;786&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;699&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Equation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;914&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;832&#8211;0&#46;996&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5730&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;715&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab976840.png"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Capacity of maximum change in platelets and creatinine clearance and the study equation to predict need for dialysis at discharge&#44; according to the multivariate model&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Sp&#58; specificity&#59; AKI&#58; acute kidney injury&#59; CI&#58; confidence interval&#59; S&#58; sensitivity&#59; PICU&#58; Paediatric Intensive Care Unit&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Area under curve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff point&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">S</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Creatinine on admission to PICU &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;734&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;645&#8211;0&#46;823&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;511&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;829&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Maximum creatinine value &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;555&#8211;0&#46;737&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;954&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;377&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Urea on admission to PICU &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;658&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;554&#8211;0&#46;762&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;820&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0467&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum pH value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;715&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;597&#8211;0&#46;832&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;852&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;544&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Bicarbonate on admission to PICU &#40;mEq&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;616&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;512&#8211;0&#46;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;596&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Phosphorus on admission to PICU &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;718&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;535&#8211;0&#46;901&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;026&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;583&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;853&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Uric acid on admission to PICU &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;938&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;866&#8211;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;844&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Protein on admission to PICU &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;662&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;559&#8211;0&#46;765&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;625&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;671&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Leukocytes on admission to PICU &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;649&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;547&#8211;0&#46;752&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6715&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;454&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;803&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum leukocyte level &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;686&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;515&#8211;0&#46;857&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;036&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;388&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;973&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Platelets on AKI diagnosis &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;671&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;573&#8211;0&#46;771&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;736&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Platelets at 24<span class="elsevierStyleHsp" style=""></span>h after AKI diagnosis &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;726&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;625&#8211;0&#46;826&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">62&#44;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;714&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;741&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum platelet count &#40;n&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;719&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;621&#8211;0&#46;816&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#44;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;872&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;464&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Capacity of analytical parameters to predict mortality&#44; according to the univariate model&#46;</p>"
        ]
      ]
      6 => array:7 [
        "identificador" => "tbl0030"
        "etiqueta" => "Table 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">CI&#58; confidence interval&#59; OR&#58; odds ratio&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Maximum creatinine value &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;309&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Minimum platelet value &#40;thousands of platelets&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;949&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;921&#8211;0&#46;979&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;052&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Sp&#58; specificity&#59; Equation&#58; &#8722;0&#46;9<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>maximum creatinine &#40;mg&#47;dl&#41;<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>0&#46;04<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>minimum platelets &#40;thousands&#47;mm<span class="elsevierStyleSup">3</span>&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>0&#46;025<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>weight &#40;kg&#41;&#59; CI&#58; confidence interval&#59; S&#58; sensitivity&#46;</p>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;646&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;555&#8211;0&#46;737&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;954&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;376&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;719&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;621&#8211;0&#46;816&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;897&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;435&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Weight &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;580&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;511&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;718&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Equation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8722;3&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;973&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;687&nbsp;\t\t\t\t\t\t\n
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                    0 => array:2 [
                      "titulo" => "Risk factors of acute renal failure in critically ill children&#46; A prospective descriptive epidemiological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Bailey"
                            1 => "V&#46; Phan"
                            2 => "C&#46; Litalien"
                            3 => "T&#46; Ducruet"
                            4 => "A&#46; Merouani"
                            5 => "J&#46; Lacroix"
                          ]
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                    0 => array:2 [
                      "doi" => "10.1097/01.pcc.0000256612.40265.67"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Crit Care Med"
                        "fecha" => "2007"
                        "volumen" => "8"
                        "paginaInicial" => "29"
                        "paginaFinal" => "35"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17251879"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
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              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognosis in critically ill children requiring continuous renal replacement therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Fernandez"
                            1 => "J&#46; L&#243;pez-Herce"
                            2 => "J&#46;C&#46; Flores"
                            3 => "D&#46; Galaviz"
                            4 => "M&#46; Ruperez"
                            5 => "K&#46;B&#46; Brandstrup"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00467-005-1907-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Nephrol"
                        "fecha" => "2005"
                        "volumen" => "20"
                        "paginaInicial" => "1473"
                        "paginaFinal" => "1477"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16047225"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical course and mortality risk factors in critically ill children requiring continuous renal replacement therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Santiago"
                            1 => "J&#46; L&#243;pez-Herce"
                            2 => "J&#46; Urbano"
                            3 => "M&#46;J&#46; Solana"
                            4 => "J&#46; del Castillo"
                            5 => "Y&#46; Ballestero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-010-1858-9"
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                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2010"
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                        "paginaInicial" => "843"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20237755"
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                ]
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              "etiqueta" => "4"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Insuficiencia renal aguda en ni&#241;os cr&#237;ticamente enfermos&#46; Estudio preliminar"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Medina"
                            1 => "J&#46; L&#243;pez-Herce"
                            2 => "Y&#46; L&#243;pez"
                            3 => "M&#46; Ant&#243;n"
                            4 => "A&#46; Concha"
                            5 => "C&#46; Rey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr"
                        "fecha" => "2004"
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            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pediatric acute kidney injury assessed by p-rifle as a prognostic factor in the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Bresolin"
                            1 => "A&#46;P&#46; Bianchini"
                            2 => "C&#46;A&#46; Haas"
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                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1007/s00467-012-2357-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Nephrol"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "485"
                        "paginaFinal" => "492"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23179195"
                            "web" => "Medline"
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            ]
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              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Modified RIFLE criteria in critically ill children with acute kidney injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Akcan-Arikan"
                            1 => "M&#46; Zapittelli"
                            2 => "L&#46;L&#46; Loftis"
                            3 => "K&#46;K&#46; Washburn"
                            4 => "L&#46;S&#46; Jefferson"
                            5 => "S&#46;L&#46; Goldstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.ki.5002231"
                      "Revista" => array:6 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2007"
                        "volumen" => "71"
                        "paginaInicial" => "1028"
                        "paginaFinal" => "1035"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17396113"
                            "web" => "Medline"
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                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Acute Kidney Injury Network Report of an initiative to improve outcomes in acute kidney injury"
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "S&#46;V&#46; Shah"
                            3 => "B&#46;A&#46; Molitoris"
                            4 => "C&#46; Ronco"
                            5 => "D&#46;G&#46; Warnock"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc5713"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2007"
                        "volumen" => "11"
                        "paginaInicial" => "R31"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17331245"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Application of the new classification criteria of the Acute Kidney Injury Network&#58; a pilot study in a pediatric population"
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                            2 => "B&#46; Altas"
                            3 => "H&#46; Erg&#252;n"
                            4 => "T&#46; Kendirli"
                            5 => "C&#46; Ates"
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Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2015.09.017

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Year/Month	Html	Pdf	Total

2024 November	10	9	19
2024 October	52	39	91
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2024 August	61	49	110
2024 July	54	22	76
2024 June	75	24	99
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2024 April	74	31	105
2024 March	60	34	94
2024 February	53	30	83
2024 January	47	24	71
2023 December	68	19	87
2023 November	52	30	82
2023 October	43	25	68
2023 September	38	20	58
2023 August	50	24	74
2023 July	50	29	79
2023 June	44	26	70
2023 May	53	30	83
2023 April	53	16	69
2023 March	53	25	78
2023 February	74	34	108
2023 January	41	37	78
2022 December	68	30	98
2022 November	71	33	104
2022 October	55	39	94
2022 September	48	32	80
2022 August	55	52	107
2022 July	42	42	84
2022 June	54	38	92
2022 May	49	40	89
2022 April	44	50	94
2022 March	60	54	114
2022 February	44	27	71
2022 January	31	43	74
2021 December	36	41	77
2021 November	36	40	76
2021 October	45	63	108
2021 September	55	52	107
2021 August	52	43	95
2021 July	26	32	58
2021 June	67	45	112
2021 May	51	50	101
2021 April	114	57	171
2021 March	78	30	108
2021 February	47	24	71
2021 January	45	24	69
2020 December	48	22	70
2020 November	48	19	67
2020 October	59	21	80
2020 September	79	17	96
2020 August	86	18	104
2020 July	71	28	99
2020 June	70	21	91
2020 May	45	25	70
2020 April	38	17	55
2020 March	28	20	48
2020 February	21	15	36
2020 January	25	25	50
2019 December	73	28	101
2019 November	41	21	62
2019 October	43	16	59
2019 September	44	8	52
2019 August	74	22	96
2019 July	28	21	49
2019 June	26	34	60
2019 May	57	21	78
2019 April	76	30	106
2019 March	41	18	59
2019 February	37	15	52
2019 January	22	27	49
2018 December	51	21	72
2018 November	125	37	162
2018 October	285	39	324
2018 September	153	15	168
2018 June	4	0	4
2018 May	15	0	15
2018 April	76	0	76
2018 March	172	0	172
2018 February	8	0	8
2018 January	11	0	11
2017 December	12	0	12
2017 November	19	0	19
2017 October	18	0	18
2017 September	17	0	17
2017 August	16	0	16
2017 July	20	0	20
2017 June	21	5	26
2017 May	10	6	16
2017 April	17	5	22
2017 March	9	1	10
2017 February	10	2	12
2017 January	7	3	10
2016 December	31	15	46
2016 November	24	4	28
2016 October	29	11	40
2016 September	33	10	43
2016 August	28	4	32
2016 July	15	5	20

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