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Published on: February 2, 2021
Acute kidney injury in pediatric patients
David M Kwiatkowski1, Scott M Sutherland2
1Division of Cardiology, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.
Insights
Pediatric acute kidney injury (AKI) affects hospitalized children, particularly the critically ill. Early detection and prevention strategies are crucial for improving outcomes in pediatric AKI.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Biomarker Discovery
Background:
- Acute kidney injury (AKI) is a significant concern in hospitalized children, with higher prevalence in critically ill patients.
- Established definitions incorporating pediatric specifics have improved understanding of pediatric AKI epidemiology, risk factors, and outcomes.
- AKI and fluid overload are independently linked to adverse outcomes, including mortality.
Purpose of the Study:
- To review the current understanding of pediatric acute kidney injury (AKI).
- To highlight advancements in diagnostic strategies and the development of preventative measures for pediatric AKI.
- To emphasize the importance of early detection in improving patient outcomes.
Main Methods:
- Review of current literature on pediatric acute kidney injury (AKI).
- Analysis of epidemiological data, risk factors, and outcomes associated with pediatric AKI.
- Discussion of diagnostic challenges and emerging biomarker and risk stratification techniques.
Main Results:
- Pediatric AKI incidence is 5% in non-critically ill and 27% in critically ill children.
- Current diagnostic methods (urine output, creatinine) present challenges in pediatric populations.
- Novel biomarkers and risk stratification methods are enhancing AKI detection and diagnosis.
Conclusions:
- While specific treatments for AKI are lacking, preventative strategies are under development.
- Early detection of pediatric AKI shows promise for improving patient outcomes.
- Continued innovation in diagnostic tools is expected to drive advances in AKI management.
Abstract:
Acute kidney injury (AKI) is highly prevalent among hospitalized children, especially those who are critically ill. The incorporation of pediatric elements into consensus definitions has led to a greater understanding of pediatric AKI epidemiology, risk factors, and outcomes. The best available data suggest that AKI occurs in 5% and 27% of non-critically ill and critically ill children, respectively. Additionally, AKI and fluid overload are independently associated with worse outcomes including mortality. Currently, the diagnosis of AKI relies upon urine output and creatinine measurements, both of which pose unique problems in children. However, novel biomarker discovery and new risk stratification techniques have led to enhanced detection and diagnostic strategies. Although no specific treatments exist, strategies designed to prevent AKI are being developed and there is growing evidence that early detection may improve outcomes. We hope that advances in AKI management will follow the diagnostic innovations seen in the past decade.
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