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Subphenotypes of acute kidney injury in children

Katja M Gist1, Dana Fuhrman2, Natalja Stanski1

  • 1Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Current Opinion in Critical Care
|August 31, 2022
PubMed

Insights

This review details acute kidney injury (AKI) phenotypes in children. Understanding these distinct AKI subphenotypes is crucial for improved pediatric patient outcomes and targeted therapies.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Biomarker Discovery

Background:

  • Acute kidney injury (AKI) is a complex condition affecting both critically ill and non-critically ill children, leading to significant morbidity and mortality.
  • Emerging research highlights the heterogeneity of AKI, with distinct subphenotypes influenced by causative factors, co-existing conditions, and disease characteristics like severity and duration.
  • Novel urinary biomarkers of tubular injury are revealing previously unrecognized AKI subphenotypes, offering deeper insights into disease mechanisms.

Approach:

  • This review synthesizes current knowledge on pediatric AKI phenotypes.
  • It examines how variations in AKI presentation, severity, duration, and recurrence impact patient outcomes.
  • The role of advanced biomarkers in identifying unique AKI subphenotypes in children is explored.

Key Points:

  • Pediatric acute kidney injury (AKI) presents with diverse phenotypes that require careful characterization.
  • AKI subphenotypes vary based on etiology, clinical context, and disease trajectory.
  • Urinary biomarkers are instrumental in uncovering subtle yet significant AKI subphenotypes in children.

Conclusions:

  • Further research is essential to fully delineate the spectrum of AKI subphenotypes in pediatric populations.
  • Accurate identification of AKI phenotypes in children has significant prognostic value.
  • Understanding distinct pediatric AKI phenotypes is critical for developing targeted and effective therapeutic strategies.
Abstract

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