Renal Angina Index for Predicting Acute Kidney Injury in Critically Ill Children: A Prospective Follow-up Study Positive RAI Score as a Predictor of Severe AKI in Critically Ill Children
Journal of Pediatric Nephrology,
Vol. 13 No. 1 (2025),
12 May 2026
https://doi.org/10.22037/jpn.v12i1.47024
Abstract
Background and Aim: Renal Angina Index (RAI), which combines risk strata and clinical
injury signs of acute kidney injury (AKI) helps identify sick paediatrics at risk of developing
severe AKI. This study aimed to estimate the proportion of critically ill children with a
positive RAI score at admission who develop severe AKI on day 3 of paediatric intensive
care unit (PICU) admission.
Methods: This prospective follow-up study was done among 100 children without
preexisting kidney disease and with at least 3 days of stay in the pediatric intensive care unit
of a tertiary care teaching hospital in South India. The RAI score was calculated at admission.
The KDIGO score was applied on day 3 of admission. The proportion of children with a
positive RAI score (8 or more) who developed severe AKI (the kidney disease: Improving
global outcomes [KDIGO] stages 2 and 3) was calculated. Short-term outcomes in terms of
duration of hospital stay and mortality were also studied.
Results: A total of 100 children aged 29 days to 12 years were included in the study. Fifty-one
percent of them were found to be RAI-positive at admission. Also, 41.2% of RAI-positive
children developed severe AKI on day 3 of admission. Among the 31% of children who were
diagnosed with severe AKI by day 3 of admission, 67.7% had a positive RAI score at the
time of admission (P<0.05). AKI was found to be associated with increased median duration
of hospital stay.
Conclusion: The RAI score can predict AKI in critically ill children.
- Acute kidney injury (AKI)
- Child
- Renal angina index (RAI)
- Creatinine
- Biomarkers
How to Cite
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