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Recognition and management of acute kidney injury in children

Cal Robinson1, Peter Wong1, Rahul Chanchlani1

  • 1Canadian Paediatric Society, Community Paediatrics Committee, Ottawa, Ontario, Canada.

Paediatrics & Child Health
|March 25, 2026
PubMed

Insights

Acute kidney injury (AKI) is common in hospitalized children, but under-recognized in Canada. This statement reviews AKI epidemiology, diagnosis, management, and follow-up care for neonates and children.

Area of Science:

  • Pediatrics
  • Nephrology
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) significantly impacts hospitalized neonates and children, leading to adverse short- and long-term health outcomes.
  • Early detection and prevention are crucial for mitigating AKI progression and associated complications.
  • Paediatric AKI remains under-recognized in Canada, with highly variable follow-up care.

Purpose of the Study:

  • To review the epidemiology and risk factors associated with paediatric AKI.
  • To outline strategies for the diagnosis and management of AKI in hospitalized children.
  • To discuss the long-term risks of childhood AKI and recommend surveillance protocols, with a specific focus on neonatal considerations.

Main Methods:

  • Literature review and synthesis of current evidence on paediatric AKI.
  • Analysis of epidemiological data and risk factors.
  • Development of recommendations for clinical practice and follow-up care.

Main Results:

  • AKI is a prevalent condition in hospitalized children with significant morbidity.
  • Current diagnostic and management approaches require optimization for early detection and intervention.
  • Long-term surveillance is essential for managing the sequelae of childhood AKI.

Conclusions:

  • There is a critical need to improve the recognition, diagnosis, and management of AKI in Canadian pediatric populations.
  • Standardized follow-up care protocols are necessary to mitigate long-term adverse outcomes.
  • Special attention must be paid to the unique aspects of neonatal AKI detection and management.

Keywords:
Acute kidney injuryAcute renal failureChronic kidney diseaseNeonatal nephrologyPaediatric nephrology

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