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The relevance of acute kidney injury in dehydrated children

Dovilė Ruzgienė1, Ernestas Viršilas1, Augustina Jankauskienė1

  • 1Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Frontiers in Pediatrics
|December 25, 2025
PubMed

Insights

Dehydration is a major cause of acute kidney injury in children, but it is understudied. This review highlights key risk factors and short-term outcomes, emphasizing the need for long-term studies.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Public Health

Background:

  • Dehydration is the primary cause of acute kidney injury (AKI) in children, yet its impact on the general pediatric population is not well understood.
  • Existing research on pediatric AKI often overlooks dehydration-associated cases, focusing instead on post-cardiac surgery or critically ill children.

Purpose of the Study:

  • To systematically review the literature on pediatric acute kidney injury caused by dehydration.
  • To characterize the burden, clinical relevance, incidence, severity, risk factors, and outcomes of dehydration-associated AKI in children.

Main Methods:

  • A PRISMA-guided systematic search of PubMed and EBSCO databases (2010-2025) was performed.
  • Risk of bias was assessed using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias 2.0 tool.
  • Included studies examined AKI incidence, severity, short-term and long-term effects, and risk factors.

Main Results:

  • 31 studies met inclusion criteria, predominantly cohort and case-control studies.
  • Higher AKI incidence was noted in younger children; hypovolemia, sepsis, and shock were significant risk factors.
  • Stage I AKI was most common; short-term outcomes included recovery and mortality, with limited long-term data.

Conclusions:

  • Prerenal AKI is prevalent in high-risk pediatric settings and often multifactorial.
  • Most dehydration-associated AKI cases in children appear to have a single primary cause.
  • Long-term follow-up studies are crucial to understand the enduring effects of pediatric AKI and its progression to chronic kidney disease.
Abstract

Keywords:
acute kidney injurychildrendehydrationoutcomesvolume depletion

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