Pediatric Acute Kidney Injury: Focusing on Diagnosisand Management

ABSTRACT

Acute kidney injury (AKI) is common in critically ill children, and is associated withincreased mortality and long-term renal sequelae. The definition of pediatric AKIwas standardized based on elevation in serum creatinine levels or decrease inurine output; accordingly, epidemiological studies have ensued. Although newbiomarkers appear to detect AKI earlier and predict prognosis more accuratelythan traditional markers, they are not frequently used in clinical setting. There isno validated pharmacological intervention for AKI, so prevention and early detectionare the mainstays of treatment. For high risk or early stage AKI patients,optimization of volume status and blood pressure, avoidance of nephrotoxins,and sufficient nutritional support are necessary, and have been demonstrated tobe effective in preventing the occurrence of AKI and improving prognosis. Nevertheless,renal replacement therapy is needed when conservative care fails.