Related Experiment Video

Updated: Oct 1, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

Acute renal failure

Sharon Phillips Andreoli1

  • 1Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis, Indiana 46202, USA. sandreol@uipui.edu

Current Opinion in Pediatrics
|May 1, 2002
PubMed

Insights

Hypoxic/ischemic acute renal failure is common in hospitalized children. New insights into its causes and treatments, like hemofiltration, are improving care for pediatric acute kidney injury.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine

Background:

  • Acute renal failure (ARF) in children presents with elevated creatinine and nitrogenous waste, impairing fluid and electrolyte balance.
  • Causes include prerenal disease, intrinsic renal failure (e.g., hypoxic/ischemic insults), and obstructive uropathy.

Purpose of the Study:

  • Focus on hypoxic/ischemic ARF, a frequent cause of hospital-acquired ARF in children.
  • Review pediatric ARF epidemiology, incidence, and novel pathogenetic insights.
  • Discuss evolving therapeutic strategies for pediatric ARF.

Main Methods:

  • Literature review focusing on hypoxic/ischemic acute renal failure in pediatric populations.
  • Analysis of recent findings on ARF pathogenesis, including nitric oxide/endothelin metabolism, inflammation, and polarity.
  • Evaluation of current and emerging treatment modalities.

Main Results:

  • Hypoxic/ischemic insults are a primary driver of hospital-acquired ARF in children.
  • Pathogenesis involves complex hemodynamic, inflammatory, and cellular polarity changes.
  • "Renal dose" dopamine has proven ineffective in adults; hemofiltration is gaining traction.

Conclusions:

  • Understanding the pathophysiology of pediatric ARF is crucial for effective management.
  • Therapeutic approaches are shifting, with hemofiltration emerging as a key treatment option.
  • Continued research is needed to optimize the care of children with acute kidney injury.

Related Concept Videos

Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Dialysis01:27

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...