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Preventing pediatric acute kidney injury: is it even possible?

Laura H Kim1, Stuart L Goldstein2,3

  • 1Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. laurakimkw@gmail.com.

Pediatric Nephrology (Berlin, Germany)
|June 12, 2026
PubMed

Insights

Pediatric acute kidney injury (AKI) prevention improves with better risk tools and strategies. This review covers current AKI prevention methods, pathophysiology, and future interventions for hospitalized children.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Biomarker Research

Background:

  • Pediatric acute kidney injury (AKI) is a common and serious condition in hospitalized children, leading to significant short- and long-term health issues.
  • Advances in kidney tubular biomarkers and risk prediction tools enhance the identification of children at high risk for AKI.
  • Current AKI prevention primarily relies on established strategies like fluid management, hemodynamic support, and avoiding nephrotoxic agents.

Purpose of the Study:

  • To review contemporary risk stratification tools for pediatric AKI.
  • To summarize key pathophysiological aspects of AKI relevant to prevention.
  • To evaluate established, pharmacological, and extracorporeal interventions for preventing pediatric AKI.

Main Methods:

  • Literature review of contemporary risk stratification tools in AKI.
  • Review of AKI pathophysiology pertinent to prevention strategies.
  • Appraisal of established and emerging pharmacological and extracorporeal interventions for pediatric AKI prevention.

Main Results:

  • Improved identification of high-risk pediatric patients through advanced biomarkers and prediction tools.
  • Established kidney-protective strategies remain central to AKI prevention.
  • Emerging pharmacological and extracorporeal interventions show promise for AKI prevention.

Conclusions:

  • Contemporary risk stratification and established protective strategies form the basis of pediatric AKI prevention.
  • Ongoing research and clinical trials are refining preventive approaches.
  • There is cautious optimism for improved outcomes in pediatric AKI prevention through targeted strategies.

Keywords:
Acute kidney injuryBiomarkersKidney protective strategiesPediatricPreventive strategy

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