Cureus. 2026 Jun 6;18(6):e110338. doi: 10.7759/cureus.110338. eCollection 2026 Jun.
ABSTRACT
Objective This study aimed to evaluate the effectiveness of the Renal Angina Index (RAI) in predicting acute kidney injury (AKI) among pediatric ICU (PICU) patients. Methods This prospective observational study, conducted at Gandhi Medical College, Bhopal, from September 2022 to February 2024, included 300 PICU patients aged one month to 13 years. RAI was calculated 24 hours post-admission, and its correlation with the development of AKI after 24 hours of admission was analyzed using SPSS Statistics version 25 (IBM Corp., Armonk, NY). Results The mean patient age was 36.16 months (standard deviation (SD): 15.08); 50.7% were male. AKI occurred in 5% of patients. Mortality increased significantly across RAI categories: 0% (low-risk), 7.5% (moderate-risk), and 68.8% (high-risk) (p < 0.001). RAI at 24 hours demonstrated excellent discriminatory ability with an area under the curve (AUC) of 0.87; 95% confidence interval (CI): 0.80-0.94. At a threshold ≥ 8, RAI showed 81.8% sensitivity and 97.2% specificity, with a 75.0% positive predictive value (PPV). Strong associations existed between RAI and vasopressor support, PRISM (Pediatric Risk of Mortality) scores, and KDIGO (Kidney Disease: Improving Global Outcomes)-documented AKI (all p < 0.001). Conclusions RAI can predict AKI in critically ill pediatric patients, enabling early intervention. The 24-hour assessment provides valuable prognostic information for patient risk stratification.
PMID:42416932 | PMC:PMC13341005 | DOI:10.7759/cureus.110338
