Acute Kidney Injury in Children

Scott M Sutherland1, David M Kwiatkowski1

  • 1Division of Nephrology, Department of Pediatrics, Stanford University, Palo Alto, CA; and Division of Cardiology, Department of Pediatrics, Stanford University, Palo Alto, CA.

Insights

Pediatric acute kidney injury (AKI) is increasingly common in hospitalized children. Improved definitions and diagnostics, including urinary biomarkers, enhance understanding, but effective treatments remain elusive.

Area of Science:

  • Pediatrics
  • Nephrology

Background:

  • Acute kidney injury (AKI) is a frequent complication in hospitalized children.
  • Recent advancements have improved understanding of pediatric AKI epidemiology, incidence, risk factors, and outcomes.

Purpose of the Study:

  • To summarize current understanding of pediatric acute kidney injury.
  • To highlight advancements in AKI diagnosis and its associated adverse outcomes.

Main Methods:

  • Review of current literature on pediatric AKI.
  • Analysis of diagnostic strategies beyond serum creatinine.
  • Inclusion of oliguria and urinary biomarkers in diagnostic considerations.

Main Results:

  • Pediatric AKI is associated with longer hospital stays and increased mortality.
  • Diagnostic approaches have evolved, emphasizing oliguria and urinary biomarkers.

Conclusions:

  • While diagnostic and definitional progress in pediatric AKI is significant, effective treatments are still needed.
  • Future research should focus on developing and testing interventions for AKI in children.

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...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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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...
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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...
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Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
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