Related Experiment Video

Updated: Aug 5, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

Acute Kidney Injury in Critically Ill Children: A Retrospective Single-Center Study

Samah Al-Harbi1,2, Fatmah Saad Waggass3, Nadeem Shafique Butt4

  • 1Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia.

Children (Basel, Switzerland)
|July 28, 2026
PubMed

Insights

Acute kidney injury (AKI) in critically ill children is common, with severity linked to worse outcomes. Early recognition and management are crucial for improving pediatric intensive care unit (PICU) survival.

Area of Science:

  • Pediatric Critical Care Medicine
  • Nephrology
  • Pediatric Intensive Care Unit (PICU) Research

Background:

  • Acute kidney injury (AKI) significantly impacts morbidity and mortality in critically ill children.
  • Understanding AKI's incidence and characteristics in pediatric intensive care units (PICUs) is vital for improving patient outcomes.

Purpose of the Study:

  • To determine the incidence, clinical characteristics, and outcomes of AKI in a tertiary pediatric intensive care unit (PICU).
  • To identify factors associated with AKI development and mortality in critically ill children.

Main Methods:

  • Retrospective observational cohort study conducted from January 2018 to December 2022.
  • Included children aged 29 days to 14 years admitted to the PICU for at least 48 hours.
  • AKI defined and staged using the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) criteria; excluded neonates, CKD patients, and elective admissions.

Main Results:

  • The incidence of AKI was 13.5% (162/1200 admissions), with Stages 1, 2, and 3 occurring in 27.2%, 39.5%, and 33.3% of cases, respectively.
  • Increased AKI severity correlated with younger age, higher inotropic support needs, and prolonged mechanical ventilation (p < 0.05).
  • PICU mortality was 16.7% overall, rising to 27.8% in Stage 3 AKI (p = 0.006); inotropic support, complications, and PRISM IV score predicted mortality.

Conclusions:

  • AKI severity is a significant predictor of adverse clinical outcomes in critically ill children.
  • Effective management strategies include early AKI recognition, hemodynamic stabilization, prompt nephrology consultation, and diligent post-AKI follow-up.
Abstract

Keywords:
KDIGO criteriaacute kidney injurycritical caremortalitypediatric intensive care unitrenal replacement therapy

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...