# Developing a Precision Medicine Approach to Pediatric Sepsis-Associated Acute Kidney Injury: Identification of Unique Subphenotypes and Strategies for Bedside Implementation

> **NIH NIH K23** · CINCINNATI CHILDRENS HOSP MED CTR · 2024 · $191,876

## Abstract

PROJECT SUMMARY/ABSTRACT:
Septic shock impacts 10% of children admitted to the pediatric intensive care unit, 25% of whom die. Outcomes
are particularly poor in those who suffer sepsis-associated acute kidney injury (SA-AKI), a heterogeneous
syndrome driven by the dysregulated host immune response to infection, and for which limited treatment options
exist. Informed by existing adult literature and a strong foundation of preliminary data, Dr. Stanski’s proposal
seeks to develop a precision medicine approach to management of these high risk children with septic shock
and SA-AKI, by leveraging clinical and biomarker data to identify unique SA-AKI subphenotypes that may inform
vasoactive medication selection at the bedside. The results from these studies will guide future prospective work
to identify treatment strategies for pediatric SA-AKI, and improve outcomes for children with septic shock as a
whole. Candidate: Dr. Natalja Stanski is an Assistant Professor of Pediatric Critical Care Medicine at the
University of Cincinnati College of Medicine and Cincinnati Children’s Hospital Medical Center (CCHMC). She
has a strong early track record of patient-oriented research in the areas of acute kidney injury and sepsis
precision medicine, focusing on identifying strategies to characterize syndrome heterogeneity. Dr. Stanski’s long-
term goal is to become an independent physician-scientist leading precision-medicine informed patient-oriented
research to improve outcomes for children with sepsis and SA-AKI. As such, her training goals as part of this
award include gaining advanced knowledge in the following areas: design and conduct of patient-oriented
research (including clinical trials), implementation science and qualitative research methodologies, advanced
biostatistics (including techniques for cluster analysis), and content expertise in precision medicine, sepsis and
SA-AKI. To accomplish these goals, Dr. Stanski’s career development plan includes formal coursework in
advanced biostatistics, clinical trial management, implementation science and qualitative research;
individualized expert mentoring; training by expert consultants; and completion of the proposed research aims.
Research: The aims of this study are: 1) to use cluster analysis methodology to identify novel pediatric SA-AKI
clinical subphenotypes and describe their associations with outcomes and serum biomarker profiles, and 2) to
use Implementation Mapping to develop a rigorous, theory-based implementation plan for personalized
vasoactive selection in children with septic shock and SA-AKI. This application leverages the outstanding
research infrastructure at CCHMC, and the support of a formidable expert mentorship, consultant and
collaborator team. Specifically, Dr. Stanski’s access to the existing large patient datasets and biorepositories
necessary to conduct this important work makes her uniquely suited to complete her proposed research aims.
The support and training provided by this ...

## Key facts

- **NIH application ID:** 10875426
- **Project number:** 5K23GM151444-02
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Natalja L. Stanski
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $191,876
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10875426

## Citation

> US National Institutes of Health, RePORTER application 10875426, Developing a Precision Medicine Approach to Pediatric Sepsis-Associated Acute Kidney Injury: Identification of Unique Subphenotypes and Strategies for Bedside Implementation (5K23GM151444-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10875426. Licensed CC0.

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