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2026, Number 1

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Rev Mex Pediatr 2026; 93 (1)

Utility of the STARZ scale for predicting acute kidney injury in newborns admitted in a Neonatal Intensive Care Unit

García-Martínez D, Escobedo-Berumen L, Romo-Vázquez JC, Gerardo-del HMN, Lezama-Armenta A
Full text How to cite this article 10.35366/123104

DOI

DOI: 10.35366/123104
URL: https://dx.doi.org/10.35366/123104

Language: Spanish
References: 17
Page: 13-19
PDF size: 838.23 Kb.


Key words:

acute kidney injury, neonates, neonatal intensive care unit, STARZ score, AKI prediction.

ABSTRACT

Introduction: acute kidney injury (AKI) in newborns is a frequent complication in the neonatal intensive care unit (NICU). Early identification is key to optimizing clinical management. Objective: to evaluate the usefulness of the STARZ score for predicting AKI in neonates hospitalized in a NICU. Material and methods: a retrospective study was conducted. The STARZ score was applied to all patients, and its diagnostic performance was compared against confirmed cases of AKI according to the KDIGO criteria adapted for neonates, considered the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the ROC curve were calculated. Results: 456 neonates were included, of whom 32 (7%) developed AKI. The STARZ score showed a sensitivity of 96.9%, specificity of 78.3%, PPV of 25.2%, and NPV of 99.7%. The area under the curve was 0.977. Conclusions: the STARZ score demonstrated high diagnostic performance for predicting AKI in neonates. Its application in the NICU could facilitate early detection of AKI, optimize renal monitoring, and improve clinical decision-making.


REFERENCES

  1. Gorga SM, Murphy HJ, Selewski DT. An update on neonatal and pediatric acute kidney injury. Curr Pediatr Rep. 2018; 6(4): 278-290.

  2. Kaur S, Jain S, Saha A, Chawla D, Parmar VR, Basu S. Evaluation of glomerular and tubular renal function in neonates with birth asphyxia. Ann Trop Paediatr. 2011; 31(2): 129-134.

  3. Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE et al. Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study. Lancet Child Adolesc Health. 2017; 1(3): 184-194.

  4. Parikh CR, Han G. Variation in performance of kidney injury biomarkers due to cause of acute kidney injury. Am J Kidney Dis. 2013; 62(6): 1023-1026.

  5. Wazir S, Sethi SK, Agarwal G, Raina R, Wazir V, Darbari A et al. Neonatal acute kidney injury risk stratification score: STARZ study. Pediatr Res. 2022; 91(5): 1141-1148.

  6. Kirkley MJ, Boohaker L, Lapidus J, Askenazi DJ, Sethi SK, Wazir S et al. Acute kidney injury in neonatal encephalopathy: an evaluation of the AWAKEN database. Pediatr Nephrol. 2019; 34(1): 169-176.

  7. Stoops C, Boohaker L, Sims B, Selewski DT, Gien J, Mhanna MJ et al. The association of intraventricular hemorrhage and acute kidney injury in premature infants from the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) study. Neonatology. 2019; 116(4): 321-330.

  8. Starr MC, Charlton JR, Thorp ML, Guillet R, Mhanna MJ, Selewski DT et al. Acute kidney injury is associated with poor lung outcomes in infants born ≥ 32 weeks of gestational age. Am J Perinatol. 2020; 37(3): 231-240.

  9. Bruel A, Roze JC, Flamant C, Roussey-Kesler G, Berthelot J, Saliba E et al. Critical serum creatinine values in very preterm newborns. PLoS One. 2013; 8(1): e84892.

  10. Carmody JB, Swanson JR, Rhone ET, Charlton JR. Recognition and reporting of AKI in very low birth weight infants. Clin J Am Soc Nephrol. 2014; 9(12): 2036-2043.

  11. Gadepalli SK, Selewski DT, Drongowski RA, Mychaliska GB. Acute kidney injury in congenital diaphragmatic hernia requiring extracorporeal life support: an insidious problem. J Pediatr Surg. 2011; 46(4): 630-635.

  12. Selewski DT, Jordan BK, Askenazi DJ, Dechert RE, Sarkar S. Acute kidney injury in asphyxiated newborns treated with therapeutic hypothermia. J Pediatr. 2013; 162(4): 725-729.e1.

  13. Hussein A, Ding L, Lee KS, Mammen C, Beltempo M, Shah PS et al. Neonatal acute kidney injury: a survey of practices in Canadian neonatal intensive care units. J Perinatol. 2026. doi: 10.1038/s41372-026-02635-8.

  14. Gist KM, Wald R, Patel S, Goldstein SL. Neonatal acute kidney injury: diagnostic and prognostic considerations in the era of biomarkers. Pediatr Nephrol. 2022; 37(6): 1281-1294.

  15. Stojanovi V, Barisi N, Godi M, Doronjski A. Acute kidney injury in preterm and term neonates: evaluation of risk factors and outcomes using neonatal KDIGO criteria. Neonatology. 2020; 117(2): 212-219.

  16. Carmody JB, Charlton JR. Neonatal acute kidney injury: the need for predictive scoring systems and long-term follow-up. Neoreviews. 2020; 21(7): e437-e447.

  17. Allegaert K, van den Anker JN. Biomarkers for the prediction of neonatal acute kidney injury: current status and future directions. Arch Dis Child Fetal Neonatal Ed. 2021; 106(3): F299-F305.




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Rev Mex Pediatr. 2026;93