Morbimortality associated to acute kidney injury in patients admitted to pediatric intensive care units

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Gómez Polo, A.J. Alcaraz Romero, M.A. Gil-Ruíz Gil-Esparza, J. López-Herce Cid, M. García San Prudencio, S.N. Fernández Lafever, Á. Carrillo Álvarez" "autores" => array:7 [ 0 => array:2 [ "nombre" => "J.C." "apellidos" => "Gómez Polo" ] 1 => array:4 [ "nombre" => "A.J." "apellidos" => "Alcaraz Romero" "email" => array:1 [ 0 => "aaromero@um.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 2 => array:2 [ "nombre" => "M.A." "apellidos" => "Gil-Ruíz Gil-Esparza" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "López-Herce Cid" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "García San Prudencio" ] 5 => array:2 [ "nombre" => "S.N." "apellidos" => "Fernández Lafever" ] 6 => array:2 [ "nombre" => "Á." "apellidos" => "Carrillo Álvarez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Morbimortalidad asociada al daño renal agudo en pacientes ingresados en unidades de cuidados intensivos pediátricos" ] ] "textoCompleto" => "IntroductionAcute kidney injury (AKI) in the pediatric patient is an important problem, particularly in critically ill subjects requiring admission to the Pediatric Intensive Care Unit (PICU).AKI is a clinical syndrome characterized by a loss or sudden decrease in kidney function, with or without associated oligoanuria, and with nonspecific clinical manifestations that can include water–electrolyte imbalances.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>The incidence and severity of AKI vary greatly due to the lack of universally accepted diagnostic criteria.<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a> Indeed, there are as many as 30 different definitions of AKI. This helps explain the enormous differences in the reported incidence of AKI in the PICU (2.5–24%),<a class="elsevierStyleCrossRef" href="#bib0015">3</a> and makes it difficult to establish comparisons of the incidence and morbidity associated to AKI.<a class="elsevierStyleCrossRefs" href="#bib0020">4,5</a>In recent years there have been improvements in the standardization of the diagnosis of AKI in the pediatric patient, with adoption of the pRIFLE criteria as main definition<a class="elsevierStyleCrossRef" href="#bib0030">6</a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). These criteria imply a slight modification of the RIFLE criteria described for adult patients.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> Application of the posterior AKIN criteria<a class="elsevierStyleCrossRef" href="#bib0040">8</a> (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) has revealed no relevant differences with respect to the pRIFLE criteria.<a class="elsevierStyleCrossRef" href="#bib0025">5</a><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>In adult patients, on adopting both the RIFLE criteria and the posterior AKIN criteria,<a class="elsevierStyleCrossRefs" href="#bib0045">9–13</a> a relationship has been established between the development of AKI and patient morbidity–mortality, the latter being directly proportional to the severity of kidney injury.However, in the pediatric patient, this relationship has not been consistently demonstrated, probably because of the few studies carried out to date and the small sample sizes involved.The main aim of this study was to evaluate morbidity–mortality among children admitted to the PICU who develop AKI as defined and classified by the pRIFLE criteria.Material and methodsA retrospective, observational cohort study was carried out, based on the review of case histories and including all patients over one month of age and under 15 years of age admitted to the PICU of Gregorio Marañón University General Hospital (Madrid, Spain) during the year 2011. We excluded newborn infants and patients admitted in the postoperative period of kidney transplantation. The study was approved by the Clinical Research Ethics Committee of the hospital.The following variables were collected: age, gender, weight and reason for admission (grouped as the postoperative period of heart surgery, decompensation of heart disease unrelated to surgery, the postoperative period of other types of surgery, acute respiratory failure, and others).As morbidity indicators, we considered the need for invasive mechanical ventilation and its duration, the duration of stay both in the PICU and in hospital, and mortality.We also documented extracorporeal membrane oxygenation (ECMO) and renal replacement therapy (peritoneal dialysis or continuous renal replacement therapy), including the day of admission corresponding to the start of each technique, and its duration.Renal function was assessed on the basis of repeated blood creatinine measurements and diuresis.Kidney injury was defined and categorized using the pediatric adaptation of the RIFLE criteria (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The glomerular filtration rate was estimated from the Schwartz formula: eGFR=K×height (cm)/creatinine concentration (mg/dl). The K value depends on the age: 0.45 in patients ≤12 months, 0.55 in those between 1 and 12 years, 0.57 in females >of 12 years and 0.70 in males >12 years. We used the first three severity categories of the RIFLE, obviating categories L and E because they refer to the end outcome rather than to an acute change. Severe AKI was considered in those situations meeting the criteria of categories I or F of the pRIFLE classification.In the absence of a basal creatinine value with which to evaluate the evolutive changes for the categorization of AKI, we proceeded as follows: if the patient had a creatinine value in the 6 months prior to admission we used that value, provided it had not been obtained in the first month of life; and if no known creatinine value was available, we made use of the recent reference values for infants and children.<a class="elsevierStyleCrossRefs" href="#bib0070">14,15</a>Likewise, we recorded the time of kidney injury and its duration. Early AKI was defined as AKI developing in the first 72h after admission to the PICU (representing AKI probably related to the cause of admission), while late AKI was taken to be AKI manifesting after that time (and possibly more related to complications of the initial disease or of prolonged admission to the PICU). Prerenal injury was considered when the condition resolved in under 72h, while prolonged kidney injury was considered if it persisted for 72h or longer.<a class="elsevierStyleCrossRefs" href="#bib0080">16,17</a>In order to assess morbidity, we analyzed the need for mechanical ventilation and its duration, the duration of admission to the PICU and of admission to hospital, and patient mortality. Prolonged admission to the PICU was defined as a stay of over 12 days,<a class="elsevierStyleCrossRefs" href="#bib0090">18,19</a> while prolonged hospital admission was defined as a stay of over 28 days. In turn, prolonged mechanical ventilation was taken to represent mechanical ventilation during more than 7 days.The patients that died were excluded from the analysis of the duration of stay and of mechanical ventilation. The five children with mechanical ventilation for more than 42 days were assigned a value of 1000h.The data were processed using the SPSS® version 18.0 statistical package. The normal distribution of the quantitative variables was assessed using the Kolmogorov–Smirnov test. The data are reported as medians (P25–P75) and frequencies and percentages. Comparison of the qualitative variables was carried out using the chi-squared test and the Fisher exact test where required, while the quantitative variables were compared with the Mann–Whitney U test.The association of AKI to patient morbidity–mortality was explored by univariate and multivariate logistic regression analysis, constructing models adjusted for age, diagnosis and duration of mechanical ventilation, while models adjusted for age and diagnosis were used in the analysis of the duration of mechanical ventilation.ResultsDuring the study period, a total of 320 patients over one month of age were admitted to the PICU. Of these, 5 were excluded because they had undergone kidney transplantation, thereby leaving 315 patients for inclusion in the study. The demographic characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>The postoperative period of heart surgery was the most common cause of admission to the PICU (134 children, 42.5%). As can be seen in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>, a total of 148 children (47%) required mechanical ventilation, with a duration of 48h (13–192). The duration of stay in the PICU was 4 days (3–8), while the total duration of hospital stay was 11 days (8–22). Fifty-nine children (18.7%) had no known basal creatinine value, and in these cases we used a reference creatinine value adjusted for age.Of the 315 children, 40.6% (128 children) suffered AKI at some point during admission, and of these 107 (83.6%) developed early AKI.In relation to the diagnosis, AKI was more frequent in children subjected to heart surgery, being recorded in 78 of them (58.2%) (this representing 60.9% of the total cases of AKI) (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).The patients with AKI required mechanical ventilation significantly more often (61.7%) than the rest of the children admitted to the PICU, and the duration of mechanical ventilation was also longer. Likewise, there was a greater need for extracorporeal membrane oxygenation in the children with AKI (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).The children who developed AKI presented a significantly longer stay both in the PICU and in hospital, and also showed a higher mortality rate (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> categorizes AKI according to onset, severity and duration. A total of 58.6% of the patients presented prerenal AKI. An association was found between the severity and duration of AKI – a larger number of mild cases being found in prerenal AKI, while the more severe categories were associated to a longer duration of AKI (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>The criterion oliguria was found in very few patients: one patient with uremic hemolytic syndrome who developed anuria from admission together with creatinine 4.09mg/dl (both criteria of Failure being met) and two children with severe cardiac dysfunction requiring treatment with extracorporeal membrane oxygenation, followed by renal replacement therapy. Another 20 children in which renal replacement therapy was indicated due to water overload with altered creatinine levels and glomerular filtration met the oliguria criterion, though once renal replacement therapy had already started.Twenty-four children (18.7% of the total patients with AKI) required renal replacement therapy (continuous renal replacement therapy in 23 cases and peritoneal dialysis in one patient). The mortality rate among the patients with severe AKI (Injury or Failure) was 23.7%–this being far higher than the mortality rate among those with mild AKI (Risk) (2.7%) or the children without AKI (0.5%) (p<0.001).A very significant association was observed between AKI and a prolonged stay in the PICU and in hospital, and the need for prolonged mechanical ventilation. This association was found to be independent of the age and disease condition of the patients, after controlling for these variables in the multivariate logistic regression analysis (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>). Furthermore, a parallel increase in morbidity–mortality was recorded with increasing severity of AKI (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>).<elsevierMultimedia ident="tbl0025"></elsevierMultimedia>We subsequently conducted a separate study of the children with prerenal AKI versus those with more prolonged AKI (<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>). The patients with prerenal AKI had a longer stay in the PICU and in hospital than those without AKI, though the use and duration of mechanical ventilation did not differ. As can be seen in <a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>, the children with established AKI were younger and had greater morbidity–mortality than the children without AKI or those with prerenal AKI. A very significant association was observed between established AKI and a prolonged stay in the PICU and in hospital, and the need for prolonged mechanical ventilation, that was moreover independent of patient age or disease condition (<a class="elsevierStyleCrossRef" href="#tbl0035">Table 7</a>). No such association could be established for the children with prerenal AKI.<elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0035"></elsevierMultimedia>DiscussionThe results of our study indicate a close association between the development of AKI and morbidity–mortality among children admitted to the PICU. Likewise, morbidity–mortality risk is seen to increase with the severity of AKI.Few studies have examined the repercussion of AKI in children.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> A recent systematic review<a class="elsevierStyleCrossRef" href="#bib0025">5</a> has reported a lack of concordance among the data published by the different studies–this in part being due to heterogeneous application of the criteria of AKI, differences in the inclusion and exclusion criteria used, and variability in the type of patients studied.<a class="elsevierStyleCrossRefs" href="#bib0100">20–25</a>The use of homogeneous and common criteria for the definition of AKI in the pediatric population should allow adequate comparison of the results obtained by different studies. The pRIFLE criteria could be used for this purpose, but their heterogeneous application in the different studies published to date remains an obstacle in this respect.<a class="elsevierStyleCrossRef" href="#bib0025">5</a>In our study we included all critical children requiring admission to the PICU, independently of the type of disease condition involved or of whether admission was decided on an emergency basis or was scheduled. This approach affords a better idea of the magnitude of the problem posed by the development of AKI upon morbidity–mortality in the general pediatric population.Another limitation of the published studies is the variability of the method used to determine the reference serum creatinine value when creatinine is not known. Some publications even fail to specify this value.<a class="elsevierStyleCrossRefs" href="#bib0125">25–28</a> In our series many patients had previous creatinine values, and in the rest of the cases we used recently published reference values.<a class="elsevierStyleCrossRefs" href="#bib0070">14,15</a>The oliguria criterion has not been used in the main studies on AKI in children.<a class="elsevierStyleCrossRefs" href="#bib0110">22–24,29</a> In our study the oliguria criterion was met in few cases. A probable influencing factor in this sense is the fact that a given diuresis value (ml/kg/h) used to define oliguria becomes an increasingly strict criterion as the patient weight or size decreases, since the water supply received by the child in relation to body weight increases notoriously as the patient size decreases. An evaluation in ml/m<a class="elsevierStyleCrossRef" href="#bib0010">2</a> body surface or ml/1.73m<a class="elsevierStyleCrossRef" href="#bib0010">2</a>, i.e., adjusting for body size, would probably resolve this problem. The evaluation of oliguria can also be influenced by the difficulty in quantifying diuresis in non-catheterized children, particularly when carried out on a retrospective basis. Furthermore, the use of diuretics is a common practice in children admitted to the PICU, influenced by the large percentage of patients with heart disease (53% in our series), and this can also contribute to lesser compliance with the oliguria criterion.Of the 12 published studies attempting to relate the development of AKI to morbidity–mortality, only two contribute sufficient information to confirm that the measures used to define the presence of kidney injury reflect correct application of the pRIFLE criteria.<a class="elsevierStyleCrossRefs" href="#bib0030">6,20</a>Several studies have reported a relationship between the existence of AKI and patient mortality,<a class="elsevierStyleCrossRefs" href="#bib0100">20,21,29</a> in coincidence with our own findings. Of the four articles analyzing mortality in relation to severity according to the pRIFLE classification,<a class="elsevierStyleCrossRefs" href="#bib0085">17,20,21,29</a> only two reported a significant correlation.<a class="elsevierStyleCrossRefs" href="#bib0105">21,29</a> Such differences are probably due to the small sample sizes of the published studies and the low incidence of mortality in the PICU.The increased morbidity associated to AKI, assessed as a longer stay in the PICU, longer admission to hospital, and a longer duration of mechanical ventilation, has been confirmed by studies in both adults<a class="elsevierStyleCrossRefs" href="#bib0045">9,10,12,13</a> and children.<a class="elsevierStyleCrossRefs" href="#bib0030">6,20–22,27,29,30</a> Studies in adults moreover have reported increasing risk with increasing AKI severity based on the RIFLE criteria. Our own data coincide with these observations. However, this association had not been previously reported in the series in children.On the other hand, we have separately analyzed the children with prerenal AKI and those with established AKI, with the aim of examining the effect of temporary dysfunction versus established AKI upon patient morbidity. As expected, we found that children with established AKI suffered greater morbidity than those with prerenal AKI. Furthermore, we observed an independent relationship between established AKI and the studied morbidity parameters. The absence of this association in the children with prerenal AKI may have been influenced by the fact that the studied morbidity criteria were met in only a few of these patients (5 were subjected to mechanical ventilation during over 7 days, 10 had a PICU stay of over 12 days, and 10 were admitted to hospital for more than 28 days).Given the important morbidity–mortality associated to the development of AKI in critical children, the early adoption of measures designed to reduce the incidence and/or severity of AKI could help improve the outcome of these patients.Our study has a number of limitations: (1) its retrospective, single-center design; (2) the small number of patients included; (3) the fact that the basal eGFR of part of the patients had to be extrapolated from reference creatinine values adjusted for age; and (4) the fact that the oliguria criterion could not be adequately assessed in all the patients, since not all the children were catheterized.ConclusionsThe development of AKI in children admitted to the PICU is associated to increased morbidity–mortality. The categorization of AKI based on the pRIFLE criteria, and the use of well established definitions and criteria, allow adequate identification of the associated morbidity–mortality risk, and can contribute to the early detection of those patients at risk of suffering AKI, with the adoption of measures designed to reduce the incidence and severity of the syndrome.Conflicts of interestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:2 [ "identificador" => "xres373978" "titulo" => array:8 [ 0 => "Abstract" 1 => "Aim" 2 => "Design" 3 => "Setting" 4 => "Patients or participants" 5 => "Primary endpoints" 6 => "Results" 7 => "Conclusion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec353025" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres373977" "titulo" => array:8 [ 0 => "Resumen" 1 => "Objetivo" 2 => "Diseño" 3 => "Ámbito" 4 => "Pacientes o participantes" 5 => "Variables principales" 6 => "Resultados" 7 => "Conclusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec353026" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 10 => array:2 [ "identificador" => "xack95508" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-04-24" "fechaAceptado" => "2013-07-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec353025" "palabras" => array:4 [ 0 => "Acute kidney injury" 1 => "Pediatrics" 2 => "Intensive care" 3 => "Morbidity" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec353026" "palabras" => array:4 [ 0 => "Daño renal agudo" 1 => "Pediatría" 2 => "Cuidados Intensivos" 3 => "Morbilidad" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "AimTo describe the morbimortality associated to the development of acute kidney injury (AKI) defined by the pediatric adaptation of the RIFLE criteria in a Pediatric Intensive Care Unit (PICU). DesignA retrospective cohort study was carried out. SettingChildren admitted to a PICU in a tertiary care hospital. Patients or participantsA total of 320 children admitted to a tertiary care hospital PICU during the year 2011. Neonates and renal transplant patients were excluded. Primary endpointsAKI was defined and classified according to the pediatric adaptation to the RIFLE criteria. PICU and hospital stays, use of mechanical ventilation and mortality were used to evaluate morbimortality. ResultsA total of 315 children met the inclusion criteria, with a median age of 19 months (range 6–72). Of these patients, 128 presented AKI (73 reached the Risk category and 55 reached the injury and failure categories). Children with AKI presented a longer PICU stay (6.0 [4.0–12.5] vs 3.5 [2.0–7.0] days) and hospital stay (17 [10–32] vs 10 [7–15] days), and a greater need for mechanical ventilation (61.7 vs 36.9%). The development of AKI was an independent factor of morbidity, associated with a longer PICU and hospital stay, and with a need for longer mechanical ventilation, with a proportional relationship between increasing morbidity and the severity of AKI. ConclusionThe development of AKI in critically ill children is associated with increased morbimortality, which is proportional to the severity of renal injury." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "ObjetivoAnalizar la morbimortalidad asociada a daño renal agudo (DRA) definido por los criterios RIFLE adaptados a Pediatría en los niños que ingresan en la Unidad de Cuidados Intensivos Pediátricos (UCIP). DiseñoEstudio retrospectivo de cohorte. ÁmbitoUCIP de un hospital terciario. Pacientes o participantesTrescientos veinte niños ingresados en la UCIP en el año 2011. Se excluyeron los neonatos y los trasplantados renales. Variables principalesEl DRA fue definido con los criterios RIFLE adaptados a Pediatría. Para la valoración de la morbimortalidad se utilizó la duración de las estancias en la UCIP y en el hospital, la necesidad de ventilación mecánica y la mortalidad. ResultadosSe estudiaron 315 niños, con una mediana de edad de 19 meses (6-72). Presentaron DRA 128 niños (40,6%) (73 en la categoría de Risk [riesgo] y 55 en las categorías Injury [daño] y Failure [fallo]). Los niños con DRA presentaron mayor mortalidad (11,7%) que el resto de pacientes (0,5%), una estancia más prolongada en UCIP (6,0 [4,0-12,5] frente a 3,5 [2,0-7,0] días) y en el hospital (17 (10-32) frente a 10 (7-15] días) y más niños precisaron ventilación mecánica (61,7 frente a 36,9%). El desarrollo de DRA fue un factor independiente de morbilidad, asociado a una mayor estancia en UCIP y hospitalaria y a una ventilación mecánica más prolongada, incrementándose esta morbilidad de forma paralela a la gravedad del daño renal. ConclusiónEl desarrollo de DRA en niños en estado crítico se asocia a un incremento en la morbimortalidad, que es directamente proporcional a la magnitud de la gravedad del daño renal." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Gómez Polo JC, Alcaraz Romero AJ, Gil-Ruíz Gil-Esparza MA, López-Herce Cid J, García San Prudencio M, Fernández Lafever SN, et al. Morbimortalidad asociada al daño renal agudo en pacientes ingresados en unidades de cuidados intensivos pediátricos. Med Intensiva. 2014;38:430–437." ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "eGFR: estimated glomerular filtration rate." "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"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Serum creatinine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Diuresis \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Risk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increase×1.5–2 or decrease eGFR>25% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.5ml/kg/h×8h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Injury \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increase×2–3 or decrease eGFR>50% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.5ml/kg/h×16h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increase >3-fold or decrease eGFR>75% or eGFR<35ml/min/1.73m<a class="elsevierStyleCrossRef" href="#bib0010">2</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.3ml/kg/h×24h or anuria>12h \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab565999.png" ] ] ] ] "descripcion" => array:1 [ "en" => "RIFLE criteria of acute kidney injury adapted to pediatric patients." ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Cr: creatinine." "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"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Serum creatinine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Diuresis \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stage 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increase×1.5–2 or increase>0.3mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.5ml/kg/h×6h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stage 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increase×2–3-fold \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.5ml/kg/h×12h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stage 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increase >3-fold or Cr>4mg/dl (with acute increase>0.5mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.3ml/kg/h×24h or anuria during 12h \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab565998.png" ] ] ] ] "descripcion" => array:1 [ "en" => "AKIN criteria of acute kidney injury." ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "Cr: creatinine; AKI: acute kidney injury; ECMO: extracorporeal membrane oxygenation; PO: postoperative period; ARF: acute respiratory failure; PICU: Pediatric Intensive Care Unit; MV: mechanical ventilation." "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"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">All \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">With AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Without AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">315 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">128 (40.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">187 (59.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (months)<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (6–72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (6–72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (5–60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.692 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PO heart surgery (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">134 (42.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">78 (58.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 (41.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other heart diseases (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (10.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (33.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (66.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other PO (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (12.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (33.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (66.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ARF (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61 (19.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (14.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 (85.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Others (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 (15.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (35.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (64.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MV (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">148 (47.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79 (61.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69 (36.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duration MV<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>(h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 (13–192) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 (24–264) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (9–144) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.052 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ECMO (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (14.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal Cr<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>(mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.27 (0.22–0.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.26 (0.21–0.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.27 (0.23–0.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.901 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PICU stay<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>(days) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.0 (3.0–8.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.0 (4.0–12.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.5 (2.0–7.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total stay<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>(days) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (8–22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (10–32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (7–15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mortality (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (5.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (11.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab566001.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Median (P25–P75)." ] ] ] "descripcion" => array:1 [ "en" => "Basal characteristics of the study population." ] ] 3 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "AKI: acute kidney injury; RRT: use of renal replacement therapy.AKI global admission: presence of AKI at any time during admission. Early AKI: start within first 72h of admission.Twenty-one children without early AKI developed AKI at a later point (prerenal in 13 and after >72h in 8 cases)." "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"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">AKI global admission</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Early AKI</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">All \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><72h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">>72h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">All \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><72h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">>72h \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Risk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 (84.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (15.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 (78.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (21.9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Injury \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (55.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (44.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (42.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (57.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (8.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 (91.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (13.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (86.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">128 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 (58.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (41.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">107 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 (57.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (42.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RRT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab566000.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Distribution of acute kidney injury according to severity, start and duration." ] ] 4 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "AKI: acute kidney injury; OR: odds ratio; PICU: Pediatric Intensive Care Unit; MV: mechanical ventilation.Logistic regression analysis, odds ratio (95% CI)." "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"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">PICU stay>12 days<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Total hospital stay>28 days<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">MV>7 days<a class="elsevierStyleCrossRef" href="#tblfn0015">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-adjusted OR. AKI any grade \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.9 (1.5–5.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.8 (2.0–7.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.7 (1.3–5.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-adjusted OR. AKI category Injury \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.4 (1.5–13.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 (2.5–20.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.5 (0.6–9.5)c \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-adjusted OR. AKI category Failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.4 (4.1–26.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.3 (7.9–58.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.3 (4.8–31.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adjusted OR. AKI any grade \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.0 (1.5–5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.2 (2.1–8.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.9 (1.4–6.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adjusted OR. AKI category Injury \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 (0.7–7.6)c \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.3 (1.8–16.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 (0.6–9.2)<a class="elsevierStyleCrossRef" href="#tblfn0020">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adjusted OR. AKI category Failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.1 (2.1–18.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.7 (6.4–55.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.5 (4.5–34.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab566002.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "OR (95%CI) adjusted for age, diagnosis and use of MV." ] 1 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "b" "nota" => "OR (95%CI) adjusted for age and diagnosis." ] 2 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "c" "nota" => "Nonsignificant (p>0.05)." ] ] ] "descripcion" => array:1 [ "en" => "Association between morbidity and the development of acute kidney injury of any grade or in its severe forms (categories Injury and Failure)." ] ] 5 => array:7 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "Cr: creatinine; AKI: acute kidney injury; ECMO: extracorporeal membrane oxygenation; PO: postoperative period; ARF: acute respiratory failure; PICU: Pediatric Intensive Care Unit; MV: mechanical ventilation." "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"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Without AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Prerenal AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Established AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">187 (59.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 (23.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (16.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (months)<a class="elsevierStyleCrossRef" href="#tblfn0025">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (5–60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (8–72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (3–78)<a class="elsevierStyleCrossRef" href="#tblfn0030">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.073 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Weight (kg)<a class="elsevierStyleCrossRef" href="#tblfn0025">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.5 (6.0–16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.5 (6.8–26.0)<a class="elsevierStyleCrossRef" href="#tblfn0055">$</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.3 (4.3–17.8)<a class="elsevierStyleCrossRef" href="#tblfn0035">**</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.017 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PO heart surgery (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 (41.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (31.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (26.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other heart diseases (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (66.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (21.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (12.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other PO (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (66.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (17.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ARF (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 (85.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (9.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (4.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Others (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 (64.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (27.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (8.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MV (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69 (36.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (46.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (83.0)<a class="elsevierStyleCrossRef" href="#tblfn0040">***</a>,<a class="elsevierStyleCrossRef" href="#tblfn0050">&&&</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duration MV<a class="elsevierStyleCrossRef" href="#tblfn0025">a</a>(h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (9–144) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 (18–120) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">168 (36–528)<a class="elsevierStyleCrossRef" href="#tblfn0035">**</a>,<a class="elsevierStyleCrossRef" href="#tblfn0045">&&</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.006 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ECMO (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (33.9)<a class="elsevierStyleCrossRef" href="#tblfn0040">***</a>,<a class="elsevierStyleCrossRef" href="#tblfn0050">&&&</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal Cr<a class="elsevierStyleCrossRef" href="#tblfn0025">a</a>(mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.27 (0.23–0.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.26 (0.22–0.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.28 (0.18–0.41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.904 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PICU stay<a class="elsevierStyleCrossRef" href="#tblfn0025">a</a>(days) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.5 (2.0–7.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.0 (3.0–7.8)<a class="elsevierStyleCrossRef" href="#tblfn0060">$$</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.0 (6.5–28.0)<a class="elsevierStyleCrossRef" href="#tblfn0040">***</a>,<a class="elsevierStyleCrossRef" href="#tblfn0050">&&&</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total stay<a class="elsevierStyleCrossRef" href="#tblfn0025">a</a>(days) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (7–15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (9–22)<a class="elsevierStyleCrossRef" href="#tblfn0055">$</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (22–64)<a class="elsevierStyleCrossRef" href="#tblfn0040">***</a>,<a class="elsevierStyleCrossRef" href="#tblfn0050">&&&</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mortality (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (18.8)& \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (75.0)<a class="elsevierStyleCrossRef" href="#tblfn0035">**</a>,<a class="elsevierStyleCrossRef" href="#tblfn0050">&&&</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab566003.png" ] ] ] "notaPie" => array:8 [ 0 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "a" "nota" => "Median (P25–P75)." ] 1 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "*" "nota" => "p<0.05" ] 2 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "**" "nota" => "p≤0.01" ] 3 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "***" "nota" => "p≤0.001 vs prerenal." ] 4 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "&&" "nota" => "p≤0.01" ] 5 => array:3 [ "identificador" => "tblfn0050" "etiqueta" => "&&&" "nota" => "p≤0.001 vs no AKI." ] 6 => array:3 [ "identificador" => "tblfn0055" "etiqueta" => "$" "nota" => "p<0.05" ] 7 => array:3 [ "identificador" => "tblfn0060" "etiqueta" => "$$" "nota" => "p≤0.01 vs no AKI." ] ] ] "descripcion" => array:1 [ "en" => "Basal characteristics and morbidity according to the presence of prerenal or established acute kidney injury." ] ] 6 => array:7 [ "identificador" => "tbl0035" "etiqueta" => "Table 7" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "AKI: acute kidney injury; OR: odds ratio; PICU: Pediatric Intensive Care Unit; MV: mechanical ventilation.Logistic regression analysis, odds ratio (95% CI)." "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"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">PICU stay>12 days<a class="elsevierStyleCrossRef" href="#tblfn0065">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Total hospital stay>28 days<a class="elsevierStyleCrossRef" href="#tblfn0065">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">MV>7 days<a class="elsevierStyleCrossRef" href="#tblfn0070">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-adjusted OR for prerenal AKI any grade vs no AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 (0.6–3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 (0.6–3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9 (0.3–2.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adjusted OR for prerenal AKI any grade vs no AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.3 (0.5–3.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 (0.6–3.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9 (0.3–2.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-adjusted OR for established AKI any grade vs no AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.9 (3.2–15.0)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.4 (5.7–27.1)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.6 (3.3–17.3)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adjusted OR for established AKI any grade vs no AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.4 (1.7–11.0)<a class="elsevierStyleCrossRef" href="#tblfn0080">**</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.8 (4.8–28.6)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.3 (3.7–23.3)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-adjusted OR for established vs prerenal AKI any grade \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 (2.0–12.0)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.8 (3.5–21.7)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.4 (2.8–25.0)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adjusted OR for established vs prerenal AKI any grade \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.5 (1.3–9.7)<a class="elsevierStyleCrossRef" href="#tblfn0085">***</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.8 (2.9–20.4)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.9 (3.1–31.2)<a class="elsevierStyleCrossRef" href="#tblfn0075">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab565997.png" ] ] ] "notaPie" => array:5 [ 0 => array:3 [ "identificador" => "tblfn0065" "etiqueta" => "a" "nota" => "OR (95% CI) adjusted for age, diagnosis and duration of MV." ] 1 => array:3 [ "identificador" => "tblfn0070" "etiqueta" => "b" "nota" => "OR (95% CI) adjusted for age and diagnosis." ] 2 => array:3 [ "identificador" => "tblfn0075" "etiqueta" => "*" "nota" => "p≤0.001." ] 3 => array:3 [ "identificador" => "tblfn0080" "etiqueta" => "**" "nota" => "p<0.005." ] 4 => array:3 [ "identificador" => "tblfn0085" "etiqueta" => "***" "nota" => "p<0.05." ] ] ] "descripcion" => array:1 [ "en" => "Association between morbidity and the development of prerenal and established acute kidney injury of any grade." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical review: RIFLE and AKIN – time for reappraisal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.N. Cruz" 1 => "Z. Ricci" 2 => "C. Ronco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/cc7759" "Revista" => array:6 [ "tituloSerie" => "Crit Care" "fecha" => "2009" "volumen" => "13" "paginaInicial" => "211" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19638179" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109708014162" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Necesidad y utilidad del empleo de criterios estandarizados para el diagnóstico de la disfunción renal aguda en pacientes críticos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "V. 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Morbimortality associated to acute kidney injury in patients admitted to pediatric intensive care units

Morbimortalidad asociada al daño renal agudo en pacientes ingresados en unidades de cuidados intensivos pediátricos

J.C. Gómez Polo, A.J. Alcaraz Romero

Corresponding author

aaromero@um.es

Corresponding author.

, M.A. Gil-Ruíz Gil-Esparza, J. López-Herce Cid, M. García San Prudencio, S.N. Fernández Lafever, Á. Carrillo Álvarez

Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Acute kidney injury &#40;AKI&#41; in the pediatric patient is an important problem&#44; particularly in critically ill subjects requiring admission to the Pediatric Intensive Care Unit &#40;PICU&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">AKI is a clinical syndrome characterized by a loss or sudden decrease in kidney function&#44; with or without associated oligoanuria&#44; and with nonspecific clinical manifestations that can include water&#8211;electrolyte imbalances&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The incidence and severity of AKI vary greatly due to the lack of universally accepted diagnostic criteria&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Indeed&#44; there are as many as 30 different definitions of AKI&#46; This helps explain the enormous differences in the reported incidence of AKI in the PICU &#40;2&#46;5&#8211;24&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and makes it difficult to establish comparisons of the incidence and morbidity associated to AKI&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In recent years there have been improvements in the standardization of the diagnosis of AKI in the pediatric patient&#44; with adoption of the pRIFLE criteria as main definition<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; These criteria imply a slight modification of the RIFLE criteria described for adult patients&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Application of the posterior AKIN criteria<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; has revealed no relevant differences with respect to the pRIFLE criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">In adult patients&#44; on adopting both the RIFLE criteria and the posterior AKIN criteria&#44;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#8211;13</span></a> a relationship has been established between the development of AKI and patient morbidity&#8211;mortality&#44; the latter being directly proportional to the severity of kidney injury&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">However&#44; in the pediatric patient&#44; this relationship has not been consistently demonstrated&#44; probably because of the few studies carried out to date and the small sample sizes involved&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The main aim of this study was to evaluate morbidity&#8211;mortality among children admitted to the PICU who develop AKI as defined and classified by the pRIFLE criteria&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Material and methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">A retrospective&#44; observational cohort study was carried out&#44; based on the review of case histories and including all patients over one month of age and under 15 years of age admitted to the PICU of Gregorio Mara&#241;&#243;n University General Hospital &#40;Madrid&#44; Spain&#41; during the year 2011&#46; We excluded newborn infants and patients admitted in the postoperative period of kidney transplantation&#46; The study was approved by the Clinical Research Ethics Committee of the hospital&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The following variables were collected&#58; age&#44; gender&#44; weight and reason for admission &#40;grouped as the postoperative period of heart surgery&#44; decompensation of heart disease unrelated to surgery&#44; the postoperative period of other types of surgery&#44; acute respiratory failure&#44; and others&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">As morbidity indicators&#44; we considered the need for invasive mechanical ventilation and its duration&#44; the duration of stay both in the PICU and in hospital&#44; and mortality&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">We also documented extracorporeal membrane oxygenation &#40;ECMO&#41; and renal replacement therapy &#40;peritoneal dialysis or continuous renal replacement therapy&#41;&#44; including the day of admission corresponding to the start of each technique&#44; and its duration&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Renal function was assessed on the basis of repeated blood creatinine measurements and diuresis&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Kidney injury was defined and categorized using the pediatric adaptation of the RIFLE criteria &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The glomerular filtration rate was estimated from the Schwartz formula&#58; eGFR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>height &#40;cm&#41;&#47;creatinine concentration &#40;mg&#47;dl&#41;&#46; The <span class="elsevierStyleItalic">K</span> value depends on the age&#58; 0&#46;45 in patients &#8804;12 months&#44; 0&#46;55 in those between 1 and 12 years&#44; 0&#46;57 in females &#62;of 12 years and 0&#46;70 in males &#62;12 years&#46; We used the first three severity categories of the RIFLE&#44; obviating categories L and E because they refer to the end outcome rather than to an acute change&#46; Severe AKI was considered in those situations meeting the criteria of categories I or F of the pRIFLE classification&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the absence of a basal creatinine value with which to evaluate the evolutive changes for the categorization of AKI&#44; we proceeded as follows&#58; if the patient had a creatinine value in the 6 months prior to admission we used that value&#44; provided it had not been obtained in the first month of life&#59; and if no known creatinine value was available&#44; we made use of the recent reference values for infants and children&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Likewise&#44; we recorded the time of kidney injury and its duration&#46; Early AKI was defined as AKI developing in the first 72<span class="elsevierStyleHsp" style=""></span>h after admission to the PICU &#40;representing AKI probably related to the cause of admission&#41;&#44; while late AKI was taken to be AKI manifesting after that time &#40;and possibly more related to complications of the initial disease or of prolonged admission to the PICU&#41;&#46; Prerenal injury was considered when the condition resolved in under 72<span class="elsevierStyleHsp" style=""></span>h&#44; while prolonged kidney injury was considered if it persisted for 72<span class="elsevierStyleHsp" style=""></span>h or longer&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">In order to assess morbidity&#44; we analyzed the need for mechanical ventilation and its duration&#44; the duration of admission to the PICU and of admission to hospital&#44; and patient mortality&#46; Prolonged admission to the PICU was defined as a stay of over 12 days&#44;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19</span></a> while prolonged hospital admission was defined as a stay of over 28 days&#46; In turn&#44; prolonged mechanical ventilation was taken to represent mechanical ventilation during more than 7 days&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The patients that died were excluded from the analysis of the duration of stay and of mechanical ventilation&#46; The five children with mechanical ventilation for more than 42 days were assigned a value of 1000<span class="elsevierStyleHsp" style=""></span>h&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The data were processed using the SPSS<span class="elsevierStyleSup">&#174;</span> version 18&#46;0 statistical package&#46; The normal distribution of the quantitative variables was assessed using the Kolmogorov&#8211;Smirnov test&#46; The data are reported as medians &#40;P25&#8211;P75&#41; and frequencies and percentages&#46; Comparison of the qualitative variables was carried out using the chi-squared test and the Fisher exact test where required&#44; while the quantitative variables were compared with the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The association of AKI to patient morbidity&#8211;mortality was explored by univariate and multivariate logistic regression analysis&#44; constructing models adjusted for age&#44; diagnosis and duration of mechanical ventilation&#44; while models adjusted for age and diagnosis were used in the analysis of the duration of mechanical ventilation&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0100" class="elsevierStylePara elsevierViewall">During the study period&#44; a total of 320 patients over one month of age were admitted to the PICU&#46; Of these&#44; 5 were excluded because they had undergone kidney transplantation&#44; thereby leaving 315 patients for inclusion in the study&#46; The demographic characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The postoperative period of heart surgery was the most common cause of admission to the PICU &#40;134 children&#44; 42&#46;5&#37;&#41;&#46; As can be seen in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#44; a total of 148 children &#40;47&#37;&#41; required mechanical ventilation&#44; with a duration of 48<span class="elsevierStyleHsp" style=""></span>h &#40;13&#8211;192&#41;&#46; The duration of stay in the PICU was 4 days &#40;3&#8211;8&#41;&#44; while the total duration of hospital stay was 11 days &#40;8&#8211;22&#41;&#46; Fifty-nine children &#40;18&#46;7&#37;&#41; had no known basal creatinine value&#44; and in these cases we used a reference creatinine value adjusted for age&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Of the 315 children&#44; 40&#46;6&#37; &#40;128 children&#41; suffered AKI at some point during admission&#44; and of these 107 &#40;83&#46;6&#37;&#41; developed early AKI&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In relation to the diagnosis&#44; AKI was more frequent in children subjected to heart surgery&#44; being recorded in 78 of them &#40;58&#46;2&#37;&#41; &#40;this representing 60&#46;9&#37; of the total cases of AKI&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The patients with AKI required mechanical ventilation significantly more often &#40;61&#46;7&#37;&#41; than the rest of the children admitted to the PICU&#44; and the duration of mechanical ventilation was also longer&#46; Likewise&#44; there was a greater need for extracorporeal membrane oxygenation in the children with AKI &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The children who developed AKI presented a significantly longer stay both in the PICU and in hospital&#44; and also showed a higher mortality rate &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> categorizes AKI according to onset&#44; severity and duration&#46; A total of 58&#46;6&#37; of the patients presented prerenal AKI&#46; An association was found between the severity and duration of AKI &#8211; a larger number of mild cases being found in prerenal AKI&#44; while the more severe categories were associated to a longer duration of AKI &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">The criterion oliguria was found in very few patients&#58; one patient with uremic hemolytic syndrome who developed anuria from admission together with creatinine 4&#46;09<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;both criteria of Failure being met&#41; and two children with severe cardiac dysfunction requiring treatment with extracorporeal membrane oxygenation&#44; followed by renal replacement therapy&#46; Another 20 children in which renal replacement therapy was indicated due to water overload with altered creatinine levels and glomerular filtration met the oliguria criterion&#44; though once renal replacement therapy had already started&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Twenty-four children &#40;18&#46;7&#37; of the total patients with AKI&#41; required renal replacement therapy &#40;continuous renal replacement therapy in 23 cases and peritoneal dialysis in one patient&#41;&#46; The mortality rate among the patients with severe AKI &#40;Injury or Failure&#41; was 23&#46;7&#37;&#8211;this being far higher than the mortality rate among those with mild AKI &#40;Risk&#41; &#40;2&#46;7&#37;&#41; or the children without AKI &#40;0&#46;5&#37;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">A very significant association was observed between AKI and a prolonged stay in the PICU and in hospital&#44; and the need for prolonged mechanical ventilation&#46; This association was found to be independent of the age and disease condition of the patients&#44; after controlling for these variables in the multivariate logistic regression analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; Furthermore&#44; a parallel increase in morbidity&#8211;mortality was recorded with increasing severity of AKI &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">We subsequently conducted a separate study of the children with prerenal AKI versus those with more prolonged AKI &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>&#41;&#46; The patients with prerenal AKI had a longer stay in the PICU and in hospital than those without AKI&#44; though the use and duration of mechanical ventilation did not differ&#46; As can be seen in <a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>&#44; the children with established AKI were younger and had greater morbidity&#8211;mortality than the children without AKI or those with prerenal AKI&#46; A very significant association was observed between established AKI and a prolonged stay in the PICU and in hospital&#44; and the need for prolonged mechanical ventilation&#44; that was moreover independent of patient age or disease condition &#40;<a class="elsevierStyleCrossRef" href="#tbl0035">Table 7</a>&#41;&#46; No such association could be established for the children with prerenal AKI&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0035"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0155" class="elsevierStylePara elsevierViewall">The results of our study indicate a close association between the development of AKI and morbidity&#8211;mortality among children admitted to the PICU&#46; Likewise&#44; morbidity&#8211;mortality risk is seen to increase with the severity of AKI&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Few studies have examined the repercussion of AKI in children&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> A recent systematic review<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> has reported a lack of concordance among the data published by the different studies&#8211;this in part being due to heterogeneous application of the criteria of AKI&#44; differences in the inclusion and exclusion criteria used&#44; and variability in the type of patients studied&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#8211;25</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">The use of homogeneous and common criteria for the definition of AKI in the pediatric population should allow adequate comparison of the results obtained by different studies&#46; The pRIFLE criteria could be used for this purpose&#44; but their heterogeneous application in the different studies published to date remains an obstacle in this respect&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">In our study we included all critical children requiring admission to the PICU&#44; independently of the type of disease condition involved or of whether admission was decided on an emergency basis or was scheduled&#46; This approach affords a better idea of the magnitude of the problem posed by the development of AKI upon morbidity&#8211;mortality in the general pediatric population&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Another limitation of the published studies is the variability of the method used to determine the reference serum creatinine value when creatinine is not known&#46; Some publications even fail to specify this value&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#8211;28</span></a> In our series many patients had previous creatinine values&#44; and in the rest of the cases we used recently published reference values&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">The oliguria criterion has not been used in the main studies on AKI in children&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#8211;24&#44;29</span></a> In our study the oliguria criterion was met in few cases&#46; A probable influencing factor in this sense is the fact that a given diuresis value &#40;ml&#47;kg&#47;h&#41; used to define oliguria becomes an increasingly strict criterion as the patient weight or size decreases&#44; since the water supply received by the child in relation to body weight increases notoriously as the patient size decreases&#46; An evaluation in ml&#47;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> body surface or ml&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#44; i&#46;e&#46;&#44; adjusting for body size&#44; would probably resolve this problem&#46; The evaluation of oliguria can also be influenced by the difficulty in quantifying diuresis in non-catheterized children&#44; particularly when carried out on a retrospective basis&#46; Furthermore&#44; the use of diuretics is a common practice in children admitted to the PICU&#44; influenced by the large percentage of patients with heart disease &#40;53&#37; in our series&#41;&#44; and this can also contribute to lesser compliance with the oliguria criterion&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Of the 12 published studies attempting to relate the development of AKI to morbidity&#8211;mortality&#44; only two contribute sufficient information to confirm that the measures used to define the presence of kidney injury reflect correct application of the pRIFLE criteria&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;20</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Several studies have reported a relationship between the existence of AKI and patient mortality&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21&#44;29</span></a> in coincidence with our own findings&#46; Of the four articles analyzing mortality in relation to severity according to the pRIFLE classification&#44;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;20&#44;21&#44;29</span></a> only two reported a significant correlation&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;29</span></a> Such differences are probably due to the small sample sizes of the published studies and the low incidence of mortality in the PICU&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">The increased morbidity associated to AKI&#44; assessed as a longer stay in the PICU&#44; longer admission to hospital&#44; and a longer duration of mechanical ventilation&#44; has been confirmed by studies in both adults<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10&#44;12&#44;13</span></a> and children&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;20&#8211;22&#44;27&#44;29&#44;30</span></a> Studies in adults moreover have reported increasing risk with increasing AKI severity based on the RIFLE criteria&#46; Our own data coincide with these observations&#46; However&#44; this association had not been previously reported in the series in children&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">On the other hand&#44; we have separately analyzed the children with prerenal AKI and those with established AKI&#44; with the aim of examining the effect of temporary dysfunction versus established AKI upon patient morbidity&#46; As expected&#44; we found that children with established AKI suffered greater morbidity than those with prerenal AKI&#46; Furthermore&#44; we observed an independent relationship between established AKI and the studied morbidity parameters&#46; The absence of this association in the children with prerenal AKI may have been influenced by the fact that the studied morbidity criteria were met in only a few of these patients &#40;5 were subjected to mechanical ventilation during over 7 days&#44; 10 had a PICU stay of over 12 days&#44; and 10 were admitted to hospital for more than 28 days&#41;&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Given the important morbidity&#8211;mortality associated to the development of AKI in critical children&#44; the early adoption of measures designed to reduce the incidence and&#47;or severity of AKI could help improve the outcome of these patients&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Our study has a number of limitations&#58; &#40;1&#41; its retrospective&#44; single-center design&#59; &#40;2&#41; the small number of patients included&#59; &#40;3&#41; the fact that the basal eGFR of part of the patients had to be extrapolated from reference creatinine values adjusted for age&#59; and &#40;4&#41; the fact that the oliguria criterion could not be adequately assessed in all the patients&#44; since not all the children were catheterized&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusions</span><p id="par0215" class="elsevierStylePara elsevierViewall">The development of AKI in children admitted to the PICU is associated to increased morbidity&#8211;mortality&#46; The categorization of AKI based on the pRIFLE criteria&#44; and the use of well established definitions and criteria&#44; allow adequate identification of the associated morbidity&#8211;mortality risk&#44; and can contribute to the early detection of those patients at risk of suffering AKI&#44; with the adoption of measures designed to reduce the incidence and severity of the syndrome&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0220" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Aim</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">To describe the morbimortality associated to the development of acute kidney injury &#40;AKI&#41; defined by the pediatric adaptation of the RIFLE criteria in a Pediatric Intensive Care Unit &#40;PICU&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A retrospective cohort study was carried out&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Children admitted to a PICU in a tertiary care hospital&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Patients or participants</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">A total of 320 children admitted to a tertiary care hospital PICU during the year 2011&#46; Neonates and renal transplant patients were excluded&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0030">Primary endpoints</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AKI was defined and classified according to the pediatric adaptation to the RIFLE criteria&#46; PICU and hospital stays&#44; use of mechanical ventilation and mortality were used to evaluate morbimortality&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">A total of 315 children met the inclusion criteria&#44; with a median age of 19 months &#40;range 6&#8211;72&#41;&#46; Of these patients&#44; 128 presented AKI &#40;73 reached the Risk category and 55 reached the injury and failure categories&#41;&#46; Children with AKI presented a longer PICU stay &#40;6&#46;0 &#91;4&#46;0&#8211;12&#46;5&#93; vs 3&#46;5 &#91;2&#46;0&#8211;7&#46;0&#93; days&#41; and hospital stay &#40;17 &#91;10&#8211;32&#93; vs 10 &#91;7&#8211;15&#93; days&#41;&#44; and a greater need for mechanical ventilation &#40;61&#46;7 vs 36&#46;9&#37;&#41;&#46; The development of AKI was an independent factor of morbidity&#44; associated with a longer PICU and hospital stay&#44; and with a need for longer mechanical ventilation&#44; with a proportional relationship between increasing morbidity and the severity of AKI&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">Conclusion</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The development of AKI in critically ill children is associated with increased morbimortality&#44; which is proportional to the severity of renal injury&#46;</p>"
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      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0050">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar la morbimortalidad asociada a da&#241;o renal agudo &#40;DRA&#41; definido por los criterios RIFLE adaptados a Pediatr&#237;a en los ni&#241;os que ingresan en la Unidad de Cuidados Intensivos Pedi&#225;tricos &#40;UCIP&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0055">Dise&#241;o</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de cohorte&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0060">&#193;mbito</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">UCIP de un hospital terciario&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0065">Pacientes o participantes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Trescientos veinte ni&#241;os ingresados en la UCIP en el a&#241;o 2011&#46; Se excluyeron los neonatos y los trasplantados renales&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0070">Variables principales</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El DRA fue definido con los criterios RIFLE adaptados a Pediatr&#237;a&#46; Para la valoraci&#243;n de la morbimortalidad se utiliz&#243; la duraci&#243;n de las estancias en la UCIP y en el hospital&#44; la necesidad de ventilaci&#243;n mec&#225;nica y la mortalidad&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 315 ni&#241;os&#44; con una mediana de edad de 19 meses &#40;6-72&#41;&#46; Presentaron DRA 128 ni&#241;os &#40;40&#44;6&#37;&#41; &#40;73 en la categor&#237;a de Risk &#91;riesgo&#93; y 55 en las categor&#237;as Injury &#91;da&#241;o&#93; y Failure &#91;fallo&#93;&#41;&#46; Los ni&#241;os con DRA presentaron mayor mortalidad &#40;11&#44;7&#37;&#41; que el resto de pacientes &#40;0&#44;5&#37;&#41;&#44; una estancia m&#225;s prolongada en UCIP &#40;6&#44;0 &#91;4&#44;0-12&#44;5&#93; frente a 3&#44;5 &#91;2&#44;0-7&#44;0&#93; d&#237;as&#41; y en el hospital &#40;17 &#40;10-32&#41; frente a 10 &#40;7-15&#93; d&#237;as&#41; y m&#225;s ni&#241;os precisaron ventilaci&#243;n mec&#225;nica &#40;61&#44;7 frente a 36&#44;9&#37;&#41;&#46; El desarrollo de DRA fue un factor independiente de morbilidad&#44; asociado a una mayor estancia en UCIP y hospitalaria y a una ventilaci&#243;n mec&#225;nica m&#225;s prolongada&#44; increment&#225;ndose esta morbilidad de forma paralela a la gravedad del da&#241;o renal&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0080">Conclusi&#243;n</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El desarrollo de DRA en ni&#241;os en estado cr&#237;tico se asocia a un incremento en la morbimortalidad&#44; que es directamente proporcional a la magnitud de la gravedad del da&#241;o renal&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0090">Please cite this article as&#58; G&#243;mez Polo JC&#44; Alcaraz Romero AJ&#44; Gil-Ru&#237;z Gil-Esparza MA&#44; L&#243;pez-Herce Cid J&#44; Garc&#237;a San Prudencio M&#44; Fern&#225;ndez Lafever SN&#44; et al&#46; Morbimortalidad asociada al da&#241;o renal agudo en pacientes ingresados en unidades de cuidados intensivos pedi&#225;tricos&#46; Med Intensiva&#46; 2014&#59;38&#58;430&#8211;437&#46;</p>"
      ]
    ]
    "multimedia" => array:7 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">eGFR&#58; estimated glomerular filtration rate&#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"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Serum creatinine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Diuresis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Risk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Increase<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>1&#46;5&#8211;2 or decrease eGFR<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>25&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#47;h<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Increase<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>2&#8211;3 or decrease eGFR<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#47;h<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>16<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Increase &#62;3-fold or decrease eGFR<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>75&#37; or eGFR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>35<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;3<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#47;h<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>24<span class="elsevierStyleHsp" style=""></span>h or anuria<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">RIFLE criteria of acute kidney injury adapted to pediatric patients&#46;</p>"
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      1 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Cr&#58; creatinine&#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"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Serum creatinine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Diuresis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Increase<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>1&#46;5&#8211;2 or increase<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;3<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#47;h<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>6<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Increase<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>2&#8211;3-fold&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#47;h<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stage 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Increase &#62;3-fold or Cr<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;with acute increase<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;3<span class="elsevierStyleHsp" style=""></span>ml&#47;kg&#47;h<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>24<span class="elsevierStyleHsp" style=""></span>h or anuria during 12<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab565998.png"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">AKIN criteria of acute kidney injury&#46;</p>"
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      2 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
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        "mostrarFloat" => true
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Cr&#58; creatinine&#59; AKI&#58; acute kidney injury&#59; ECMO&#58; extracorporeal membrane oxygenation&#59; PO&#58; postoperative period&#59; ARF&#58; acute respiratory failure&#59; PICU&#58; Pediatric Intensive Care Unit&#59; MV&#58; mechanical ventilation&#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"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">All&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">With AKI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Without AKI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p-</span>Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">No&#46; &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">315&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">128 &#40;40&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">187 &#40;59&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;months&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;6&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;6&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;5&#8211;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;692&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Disease</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">AKI&#58; acute kidney injury&#59; RRT&#58; use of renal replacement therapy&#46;</p><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">AKI global admission&#58; presence of AKI at any time during admission&#46; Early AKI&#58; start within first 72<span class="elsevierStyleHsp" style=""></span>h of admission&#46;</p><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Twenty-one children without early AKI developed AKI at a later point &#40;prerenal in 13 and after &#62;72<span class="elsevierStyleHsp" style=""></span>h in 8 cases&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">AKI global admission</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Early AKI</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">All&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">All&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&#60;72<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&#62;72<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Risk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;84&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;15&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;78&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;21&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;55&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;44&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;42&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;57&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;8&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;91&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;13&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;86&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total AKI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75 &#40;58&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;41&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;57&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;42&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RRT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&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="spar0110" class="elsevierStyleSimplePara elsevierViewall">Distribution of acute kidney injury according to severity&#44; start and duration&#46;</p>"
        ]
      ]
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        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">AKI&#58; acute kidney injury&#59; OR&#58; odds ratio&#59; PICU&#58; Pediatric Intensive Care Unit&#59; MV&#58; mechanical ventilation&#46;</p><p id="spar0140" class="elsevierStyleSimplePara elsevierViewall">Logistic regression analysis&#44; odds ratio &#40;95&#37; CI&#41;&#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"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">PICU stay<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>12 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Total hospital stay<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>28 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">MV<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>7 days<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-adjusted OR&#46; AKI any grade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;9 &#40;1&#46;5&#8211;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;8 &#40;2&#46;0&#8211;7&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;7 &#40;1&#46;3&#8211;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-adjusted OR&#46; AKI category Injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;4 &#40;1&#46;5&#8211;13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;0 &#40;2&#46;5&#8211;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;5 &#40;0&#46;6&#8211;9&#46;5&#41;c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-adjusted OR&#46; AKI category Failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;4 &#40;4&#46;1&#8211;26&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;3 &#40;7&#46;9&#8211;58&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;3 &#40;4&#46;8&#8211;31&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adjusted OR&#46; AKI any grade&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PO heart surgery &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other heart diseases &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other PO &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ARF &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;27&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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          "leyenda" => "<p id="spar0195" class="elsevierStyleSimplePara elsevierViewall">AKI&#58; acute kidney injury&#59; OR&#58; odds ratio&#59; PICU&#58; Pediatric Intensive Care Unit&#59; MV&#58; mechanical ventilation&#46;</p><p id="spar0200" class="elsevierStyleSimplePara elsevierViewall">Logistic regression analysis&#44; odds ratio &#40;95&#37; CI&#41;&#46;</p>"
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                      "titulo" => "Urine interleukin-6 is an early biomarker of acute kidney injury in children undergoing cardiac surgery"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Dennen"
                            1 => "C&#46; Altmann"
                            2 => "J&#46; Kaufman"
                            3 => "C&#46;L&#46; Klein"
                            4 => "A&#46; Andres-Hernando"
                            5 => "N&#46;H&#46; Ahuja"
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                      "doi" => "10.1186/cc9289"
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                        "volumen" => "14"
                        "paginaInicial" => "R181"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20942931"
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        "identificador" => "xack95508"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0225" class="elsevierStylePara elsevierViewall">The authors express their gratitude to all the staff members of the Pediatric Intensive Care Unit of Gregorio Mara&#241;&#243;n University General Hospital&#46;</p>"
        "vista" => "all"
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]

Article information

ISSN: 21735727
Original language: English

DOI:10.1016/j.medine.2013.07.007

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	5	12	17
2024 October	59	45	104
2024 September	33	29	62
2024 August	55	46	101
2024 July	32	20	52
2024 June	39	36	75
2024 May	40	24	64
2024 April	43	35	78
2024 March	32	22	54
2024 February	30	34	64
2024 January	26	29	55
2023 December	26	42	68
2023 November	39	27	66
2023 October	39	28	67
2023 September	36	39	75
2023 August	29	15	44
2023 July	39	25	64
2023 June	37	22	59
2023 May	41	35	76
2023 April	39	22	61
2023 March	60	30	90
2023 February	41	31	72
2023 January	37	18	55
2022 December	96	32	128
2022 November	57	47	104
2022 October	78	29	107
2022 September	90	40	130
2022 August	67	37	104
2022 July	49	32	81
2022 June	57	17	74
2022 May	81	40	121
2022 April	107	31	138
2022 March	70	57	127
2022 February	74	30	104
2022 January	57	31	88
2021 December	79	56	135
2021 November	77	38	115
2021 October	44	65	109
2021 September	38	42	80
2021 August	29	35	64
2021 July	22	31	53
2021 June	40	31	71
2021 May	45	48	93
2021 April	124	70	194
2021 March	56	18	74
2021 February	46	21	67
2021 January	67	21	88
2020 December	32	20	52
2020 November	37	24	61
2020 October	31	27	58
2020 September	49	14	63
2020 August	31	24	55
2020 July	52	17	69
2020 June	116	9	125
2020 May	45	11	56
2020 April	56	23	79
2020 March	27	12	39
2020 February	67	36	103
2020 January	64	32	96
2019 December	51	26	77
2019 November	69	37	106
2019 October	40	15	55
2019 September	38	29	67
2019 August	41	22	63
2019 July	33	22	55
2019 June	25	17	42
2019 May	53	19	72
2019 April	24	9	33
2019 March	30	21	51
2019 February	32	31	63
2019 January	34	26	60
2018 December	65	63	128
2018 November	159	54	213
2018 October	221	24	245
2018 September	37	5	42
2018 August	16	6	22
2018 July	23	7	30
2018 June	29	7	36
2018 May	10	5	15
2018 April	21	6	27
2018 March	20	4	24
2018 February	15	5	20
2018 January	25	6	31
2017 December	21	7	28
2017 November	23	5	28
2017 October	40	6	46
2017 September	21	6	27
2017 August	12	4	16
2017 July	18	4	22
2017 June	23	15	38
2017 May	23	11	34
2017 April	26	10	36
2017 March	7	4	11
2017 February	21	7	28
2017 January	7	1	8
2016 December	44	15	59
2016 November	44	21	65
2016 October	51	30	81
2016 September	57	37	94
2016 August	45	6	51
2016 July	36	13	49

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