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Acute kidney injury in children: an update on diagnosis and treatment

James D Fortenberry1, Matthew L Paden, Stuart L Goldstein

  • 1Critical Care Division, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta at Egleston, Atlanta, GA 30322, USA. james.fortenberry@choa.org

Pediatric Clinics of North America
|May 4, 2013
PubMed

Insights

Acute kidney injury (AKI) definitions are evolving, with biomarkers improving understanding of its timing. Pediatric continuous renal replacement therapy advances care for children with AKI, often combined with other extracorporeal technologies.

Area of Science:

  • Nephrology
  • Pediatric Critical Care
  • Biomarker Discovery

Background:

  • The definition and understanding of acute kidney injury (AKI) in both adult and pediatric populations have evolved significantly.
  • Biomarker assessment is increasingly utilized to describe, define, and understand the timing of AKI onset and progression.
  • AKI presents unique challenges when associated with sepsis, septic shock, multi-organ dysfunction, and fluid overload.

Purpose of the Study:

  • To review recent changes in the concept and definition of acute kidney injury (AKI).
  • To highlight the role of biomarkers in understanding AKI.
  • To discuss advancements in the treatment of pediatric AKI, particularly continuous renal replacement therapies (CRRT).

Main Methods:

  • Literature review of recent advancements in AKI definition and biomarkers.
  • Analysis of current treatment strategies for pediatric AKI.
  • Examination of the integration of continuous renal replacement therapy (CRRT) with other extracorporeal technologies.

Main Results:

  • Biomarker assessment provides crucial insights into AKI description, definition, and timing.
  • Pediatric continuous renal replacement therapies (CRRT) have enhanced care delivery for children with AKI.
  • Combined use of CRRT with other extracorporeal technologies is becoming more prevalent and sophisticated.

Conclusions:

  • Evolving definitions and biomarker use are refining the understanding of acute kidney injury (AKI).
  • Pediatric continuous renal replacement therapy (CRRT) represents a significant improvement in managing AKI in children.
  • Future approaches focus on optimizing combined extracorporeal therapies for improved AKI management.

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