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Acute Kidney Injury
Shina Menon1, Jordan M Symons1, David T Selewski2
1Division of Nephrology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.
Pediatrics in Review
|April 30, 2023
Summary
Acute kidney injury (AKI) is common in hospitalized children, leading to serious complications. This review updates knowledge on pediatric AKI, covering its definition, diagnosis, and management.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Hospital Medicine
Background:
- Acute kidney injury (AKI) is a frequent complication in hospitalized children.
- Pediatric AKI is linked to significant adverse outcomes and complications.
- Recent multicenter studies highlight the prevalence and impact of AKI in pediatric populations.
Purpose of the Study:
- To provide a comprehensive, state-of-the-art review of acute kidney injury in children.
- To update current understanding of AKI definition, epidemiology, and outcomes.
- To detail the differential diagnosis, diagnostic approaches, and management strategies for pediatric AKI complications.
Main Methods:
- Literature review of recent multicenter studies and relevant publications.
- Synthesis of current evidence on pediatric acute kidney injury.
- Expert consensus on diagnostic and management guidelines.
Main Results:
- AKI is prevalent in hospitalized children across diverse settings.
- Common complications include electrolyte imbalances, acidosis, and fluid disorders.
- AKI is associated with increased morbidity and mortality in pediatric patients.
Conclusions:
- Acute kidney injury is a critical issue in pediatric healthcare.
- Early recognition and management are essential to mitigate complications.
- Continued research and multicenter collaboration are vital for improving outcomes in pediatric AKI.
Related Concept Videos
01:22Acute Kidney Injury I: Introduction
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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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01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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01:29Acute Kidney Injury II: Pathophysiology
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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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01:29Acute Kidney Injury III: Clinical Manifestations
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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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01:20Acute Kidney Injury V: Interprofessional Care
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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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01:22Acute Kidney Injury VI: Nursing Management
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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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