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Clinical and pathological features of acute kidney injury in children
Zhihui Li1, Zhijuan Kang, Cuirong Duan
1Academy of Pediatrics of University of South China , Changsha, Hunan , People's Republic of China and.
Insights
This study analyzed acute kidney injury (AKI) in 165 children, revealing distinct clinical and pathological features across stages 1, 2, and 3. Stage 1 AKI often involved school-aged children with acute glomerulonephritis, while stage 3 predominantly affected infants with drug or septicemia-related causes.
Area of Science:
- Pediatric Nephrology
- Clinical Pathology
- Renal Medicine
Background:
- Acute kidney injury (AKI) is a critical condition in children.
- Understanding AKI's clinical and pathological spectrum is vital for effective management.
- Diagnostic and staging criteria provide a framework for assessing AKI severity.
Purpose of the Study:
- To analyze the clinical and pathological characteristics of pediatric acute kidney injury (AKI) across different stages.
- To explore the clinical significance of these characteristics in relation to AKI staging.
- To identify key differences in etiology, presentation, and recovery among AKI stages in children.
Main Methods:
- A cohort of 165 children diagnosed with acute kidney injury (AKI) was retrospectively analyzed.
- Patients were categorized into three distinct stages (stage 1, stage 2, and stage 3) based on established AKI criteria.
- Clinical data, pathological findings, and recovery times were systematically compared across the different AKI stages.
Main Results:
- Significant variations were observed in age, etiology, pathological damage, and serum creatinine recovery time among the three AKI stages.
- Hematuria incidence and duration differed significantly across stages, with stage 1 exhibiting a longer duration of proteinuria.
- Stage 1 AKI was predominantly associated with school-aged children and acute glomerulonephritis (AGN).
- Stage 3 AKI primarily affected infants, with drugs and septicemia as common etiologies, often presenting as acute tubulointerstitial nephritis with slow renal function recovery.
Conclusions:
- Pediatric acute kidney injury (AKI) presents with distinct clinical and pathological profiles depending on the stage.
- Stage 1 AKI is often linked to acute glomerulonephritis in school-aged children.
- Stage 3 AKI in infants is frequently associated with drug-induced or septicemic causes, leading to slower renal recovery.
Objective:
Based on the diagnostic and staging criteria of acute kidney injury (AKI), we analyze the clinical and pathological characteristics of children at different stages of AKI and explored their clinical significances.
Methods:
165 children with AKI were divided into stage 1, stage 2, and stage 3 groups. Clinical and pathologic characteristics of AKI children were analyzed.
Results:
The three groups of patients showed significant differences in age, etiology, pathological damage, and the median recovery time of serum creatinine. Of the 165 patients, the incidence and duration of hematuria showed significant differences among the three groups, and the stage 1 group showed longer duration of proteinuria.
Conclusion:
The patients were largely in stage 1 and 3. The children with AKI in stage 1 were largely school-age children and acute glomerulonephritis (AGN) was the main etiology. The AKI children in stage 3 were mainly infants, of which the etiology was mainly drugs and septicemia. The pathological type was mainly acute tubulointerstitial nephritis, and the renal function recovery was slow.
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