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Acute Kidney Injury in Children: A Focus for the General Pediatrician

Giulio Rivetti1, Pietro Gizzone1, Delfina Petrone1

  • 1Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Via Luigi de Crecchio 2, 80138 Naples, Italy.

Children (Basel, Switzerland)
|August 29, 2024
PubMed

Insights

Pediatric acute kidney injury (AKI) is often missed. Early diagnosis using novel biomarkers and prompt treatment are crucial for better outcomes in children with AKI.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Biomarker Discovery

Background:

  • Acute kidney injury (AKI) in children poses diagnostic and therapeutic challenges, frequently going unrecognized.
  • Diverse etiologies contribute to pediatric AKI, including renal tubular damage, vasoconstriction, and inflammation.

Purpose of the Study:

  • To provide a comprehensive overview of pediatric AKI, covering its epidemiology, pathophysiology, diagnosis, predisposing factors, and management strategies.
  • To highlight the role of both traditional and emerging biomarkers in diagnosing pediatric AKI.

Main Methods:

  • Literature review and synthesis of current knowledge on pediatric AKI.
  • Discussion of diagnostic markers, including serum creatinine, urine output, and novel biomarkers (e.g., Cystatin C, NGAL, KIM-1, IL-18, TIMP-2, IGFBP7, urinary calprotectin, URBP4, L-FABP, clusterin).
  • Identification of pediatric conditions associated with increased AKI risk.

Main Results:

  • Pediatric AKI arises from multifactorial causes.
  • A wide array of pediatric conditions, from infections to chronic diseases, predispose children to AKI.
  • Treatment involves supportive care, fluid management, and potentially renal replacement therapy.

Conclusions:

  • Timely recognition and management of pediatric AKI are vital to prevent adverse outcomes.
  • Increased awareness and the integration of novel biomarkers can significantly improve the diagnosis and care of pediatric AKI.
  • Further research is necessary to optimize diagnostic and therapeutic approaches for pediatric AKI.

Keywords:
acute kidney injurybiomarkerschildrenchronic kidney disease

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