PERSEVERE-II Risk Model Predicts Severe Acute Kidney Injury in Pediatric Septic Shock
Published April 2020 | American Journal of Respiratory and Critical Care Medicine
When septic shock strikes in pediatric patients, every second counts—serious complications like acute kidney injury (AKI) can set in quickly. What if we could predict which patients are most at risk before AKI occurs?
A first-of-its-kind tool can help identify these patients early on, allowing for aggressive protection strategies. The Pediatric Sepsis Biomarker Risk Model (PERSEVERE-II), developed by researchers at Cincinnati Children’s, draws from biomarkers and clinical data to personalize care.
Sepsis-associated AKI is common, but the complex disease process is poorly understood. Providers must rely on prevention and supportive care, leaving patients with a lack of viable therapeutic options—and up to five times higher odds of mortality.
To better understand these patients and their needs, researchers collected clinical and laboratory data from 379 children admitted with septic shock to 14 pediatric ICUs.
The project was led by Natalja Stanski, MD, and senior author Hector Wong, MD.
Using biomarkers and platelet counts obtained within 24 hours of diagnosis, PERSEVERE-II assigned patients into risk categories. On day three of septic shock, researchers compared these results with the development of AKI. They found that PERSEVERE-II was able to predict severe AKI and identify patients who are likely to recover.
“Our study is the first to utilize biomarkers specific to sepsis immune dysregulation, as opposed to biomarkers specific to kidney tubular injury, to predict the development of sepsis-associated AKI,” Stanski says. “We believe this reframing is what allowed our model to be so successful.”
Next, researchers plan to improve the tool with new risk assessment factors and utilize its predictions to inform enrollment in clinical trials aimed at treating sepsis-associated AKI.
