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Table 3 Subgroup analysis and meta-regression for incidence of in-hospital AKI-associated mortality (excluding smaller studies with < 100 AKI patients)

From: Incidence of acute kidney injury-associated mortality in hospitalized children: a systematic review and meta-analysis

Subgroups

Studies (participants)

Incidence of mortality (%), (95 CI)

Heterogeneity (I²), P

Coefficient (95 CI)

Subgroup differences (P)

Severity of AKI

      

AKI stage 1

26 (14843)

8.19 (5.65, 10.73)

97.8, < 0.001

Reference

 

AKI stage 2

20 (8044)

13.44 (8.69, 18.19)

97.4, < 0.001

0.049 (-0.015, 0.113)

0.136

AKI stage 3

21 (8487)

27.78 (21.82, 33.74)

96.8, < 0.001

0.187 (0.123, 0.252)

< 0.001

AKI stage 1 and 2

20 (21780)

12.54 (8.05, 17.02)

99.3, < 0.001

0.040 (-0.023, 0.104)

0.211

AKI stage 2 and 3

28 (17040)

23.50 (18.62, 28.39)

98.2, < 0.001

0.146 (0.088, 0.205)

< 0.001

Age

      

< 1 month

18 (35190)

22.81 (16.84, 20.75)

99.57, < 0.001

Reference

 

> 1 month

34 (93070)

16.56 (12.37, 20.75)

99.78, < 0.001

-0.062 (-0.138, 0.013)

0.107

Study design

      

Prospective study

15 (5627)

19.34 (13.66, 25.03)

97.67, < 0.001

Reference

 

Retrospective study

44 (128049)

17.88 (13.70, 22.07)

99.90, < 0.001

-0.016 (-0.096, 0.064)

0.691

Country income classification (as per gross national income per capita)

    

Low income

5 (1443)

12.31 (5.44, 19.17)

94.80, < 0.001

Reference

 

Lower-middle income

1 (200)

Insufficient data

Insufficient data

Insufficient data

Insufficient data

Upper-middle income

12 (29821)

15.65 (8.87, 22.44)

99.8, < 0.001

0.033 (-0.097, 0.163)

0.623

High-income

35 (97956)

18.88 (14.56, 23.20)

99.8, < 0.001

0.064 (-0.052, 0.181)

0.279

Region

     

AFR

5 (1443)

12.31 (5.44, 19.17)

94.8, < 0.001

Reference

 

AMR

28 (92635)

18.66 (13.12, 24.20)

99.9, < 0.001

0.062 (-0.060, 0.184)

0.320

EMR

4 (1295)

26.69 (21.01, 32.37)

80.3, < 0.001

0.145 (-0.025, 0.315)

0.095

EUR

8 (6518)

17.77 (9.41, 26.13)

98.5, < 0.001

0.054 (-0.090, 0.199)

0.462

SEAR

2 (369)

24.73 (12.13, 37.33)

87.7, < 0.001

0.124 (-0.089, 0.337)

0.255

WPR

9 (29340)

12.64 (6.35, 18.94)

99.8, < 0.001

0.004 (-0.137, 0.145)

0.956

AKI criteria

     

KDIGO/mKDIGO

40 (50717)

16.76 (13.01, 20.51)

99.6, < 0.001

Reference

 

RIFLE/pRIFLE/nRIFLE

5 (994)

22.81 (16.28, 29.34)

83.5, < 0.001

0.059 (-0.068, 0.186)

0.364

AKIN/mAKIN

1 (100)

Insufficient data

Insufficient data

Insufficient data

Insufficient data

ICD-9/ICD-10

6 (54292)

19.91 (4.05, 35.77)

100.0, < 0.001

0.030 (-0.085, 0.145)

0.610

Miscellaneous

8 (27773)

19.96 (8.15, 31.76)

99.8, < 0.001

0.031 (-0.071, 0.134)

0.549

AKI criteria based on

     

SCr

39 (124124)

18.19 (14.08, 22.30)

99.9, < 0.001

Reference

 

SCr + UOP

18 (6376)

17.31 (11.96, 22.66)

98.0, < 0.001

-0.008 (-0.079, 0.063)

0.831

Predisposing condition

     

Prematurity-related outcomes

6 (20643)

25.88 (18.63, 33.13)

94.9, < 0.001

Reference

 

Sepsis/septic shock

3 (45946)

16.06 (11.21, 20.90)

86.5, < 0.001

-0.102 (-0.279, 0.076)

0.262

Infections

8 (2435)

14.94 (4.02, 25.86)

99.4, < 0.001

-0.112 (-0.248, 0.024)

0.108

Cardiac surgery

5 (1274)

16.27 (9.48, 23.06)

90.0, < 0.001

-0.093 (-0.246, 0.061)

0.235

Non-cardiac surgery

3 (3358)

25.98 (-1.48, 53.44)

99.6, < 0.001

-0.001 (-0.178, 0.176)

0.992

ECMO

2 (768)

39.54 (17.53, 61.55)

96.6, < 0.001

0.137 (-0.069, 0.344)

0.193

Mixed etiology

25 (53178)

14.61 (10.55, 18.67)

99.8, < 0.001

-0.112 (-0.227, 0.003)

0.056

Miscellaneous a

8 (6274)

21.00 (9.03, 32.97)

99.4, < 0.001

-0.050 (-0.186, 0.086)

0.475

  1. CI, confidence interval; AFR, African Region; AMR, Region of the Americas; EMR, Eastern Mediterranean Region; EUR, European Region; SEAR, South-East Asia Region; WHO, World Health Organization; WPR, Western Pacific Region; KDIGO, Kidney Disease: Improving Global Outcomes; mKDIGO, modified KDIGO; RIFLE, Risk, Injury, and Failure; and Loss; and End-stage kidney disease; pRIFLE, pediatric RIFLE; nRIFLE, neonatal RIFLE; AKIN, Acute Kidney Injury Network; mAKIN, modified AKIN; ICD, The International Classification of Diseases; SCr, serum creatinine; UOP, urine output; ECMO, extracorporeal membrane oxygenation
  2. a Miscellaneous predisposing conditions include crush injury, hematopoietic cell transplantation, IV antibiotics, hypoxic-ischemic encephalopathy, continuous kidney replacement therapy, malignancy, drowning, and metabolic Acidosis
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BMC Nephrology

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