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Acute Kidney Injury in Children with Polyuria: A Systematic Review

Giulio Rivetti1, Mariantonia Braile1, Anna Di Sessa1

  • 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.

Journal of Clinical Medicine
|January 10, 2026
PubMed

Insights

Acute kidney injury (AKI) can present with polyuria in children, particularly in cases of diabetic ketoacidosis (DKA) and other conditions. This review synthesizes findings on pediatric AKI and polyuria presentations.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Endocrinology

Background:

  • Acute kidney injury (AKI) and polyuria in children present diagnostic and management challenges.
  • Understanding the interplay between AKI and polyuria is crucial for pediatric patient care.

Purpose of the Study:

  • To systematically review and synthesize the presentations of AKI in children experiencing polyuria.
  • To identify underlying conditions associated with concurrent AKI and polyuria in pediatric populations.

Main Methods:

  • Systematic literature search across Embase, PubMed, and Scopus databases.
  • Inclusion of studies and case reports focusing on pediatric AKI and polyuria.
  • Methodological quality assessment of selected publications.

Main Results:

  • Data from 32 pediatric patients (mean age 11.02 years) were analyzed.
  • Polyuria was present in 26 patients, with diabetic ketoacidosis (DKA) being the most common associated condition (19 cases).
  • Among 20 patients with polyuria and available data, 9 (45%) developed AKI, with several reaching KDIGO stage 3.

Conclusions:

  • Polyuria can be an integral part of the pathophysiology of AKI in children.
  • A link between polyuria and significant AKI (KDIGO stage ≥ 2) was observed in metabolic disorders like DKA, nephrological conditions such as Bartter syndrome, and oncological cases including neuroblastoma.

Keywords:
AKIacute kidney injurychildrendiagnosispediatricpolyuria

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