Sociodemographic Disparities in Pediatric Acute Kidney Injury—The Right Questions and the Right Definitions

Ashruf and colleagues present retrospective data from the electronic medical records of more than 17 000 pediatric patients who experienced community-acquired acute kidney injury (CA-AKI) over a 20-year study period. Thiswork raises awareness of 2 critically important yet understudied topics in pediatric AKI and sets the stage for future study in these areas. Pediatric CA-AKI has historically been difficult to define owing to the paucity of baseline serum creatinine (SCr) data in children. The large database used for this study contains information from 21 million pediatric patients with a CA-AKI prevalence of less than 0.1%. A database of this size provides the opportunity to examine important questions about CA-AKI in a way that cannot be done with the small sample sizes derived from single-center or multicenter studies. Using propensity matching, the authors compared the risk of 1-year adverse outcomes, including emergency department (ED) visits, intensive care unit admissions, mechanical ventilation, and death, in patients after CA-AKI.