Abstract: TH-PO1226
Early Augmented Renal Clearance in Children with Sepsis: Incidence, Risk Factors, and Outcomes
Session Information
- Pediatric Nephrology: CV Health, CKD, AKI, Dialysis, Transplantation, and Health Services Research
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Author
- Xu, Yaya, Shanghai Jiaotong University School of Medicine Xinhua Hospital, Shanghai, China
Background
Augmented renal clearance (ARC) is increasingly recognized in critically ill children, but its prevalence and clinical significance in pediatric sepsis remain unclear. This study aimed to determine the incidence of ARC, identify associated factors from hemodynamic, oxygen metabolism, and inflammatory perspectives, and evaluate its relationship with clinical outcomes.
Methods
This retrospective single-center observational study included children aged 28 days to 16 years admitted with sepsis to a tertiary pediatric intensive care unit between January 2022 and June 2023. Clinical characteristics, laboratory findings, hemodynamic parameters, and outcomes were compared between patients with and without ARC. Univariate analysis was performed to explore factors associated with ARC.
Results
Among 69 patients, 34 (49.3%) had ARC. Compared with the non-ARC group, ARC patients were younger (median 2.4 vs 7.2 years, P<0.001), had better cardiac systolic function, including higher ejection fraction and fractional shortening (36.0% vs 32.0%, P<0.05), and showed higher C-reactive protein levels (31.0 vs 12.0 mg/L, P<0.05). No patient with ARC developed acute kidney injury, whereas 62.9% of non-ARC patients did. ARC was also associated with shorter PICU stay (median 7 vs 11 days, P<0.05), lower hospital costs, and a higher survival probability within the first 20 days. However, long-term survival was similar between groups. Fluid balance, cardiac function indices, renal resistive index, and inflammatory markers were associated with ARC in univariate analysis.
Conclusion
ARC is common in the early stage of pediatric sepsis, especially in younger children. It is associated with hemodynamic and inflammatory changes but does not appear to indicate a worse prognosis. Further studies are needed to clarify its clinical implications.
Acknowledgment
None