Abstract
Acute kidney injury (AKI) in children is associated with increased morbidity, reduced health-related quality of life, greater resource utilization, and higher mortality. Improvements in the timeliness and precision of AKI diagnosis in children are needed. In this report, we highlight existing, novel, and on-the-horizon diagnostic and risk-stratification tools for pediatric AKI, and outline opportunities for integration into clinical practice. We also summarize pediatric-specific high-risk diagnoses and exposures for AKI, as well as the potential role of real-time risk stratification and clinical decision support to improve outcomes. Lastly, the key characteristics of important pediatric AKI phenotypes will be outlined. Throughout, we identify key knowledge gaps, which represent prioritized areas of focus for future research that will facilitate a comprehensive, timely and personalized approach to pediatric AKI diagnosis and management.
Original language | English (US) |
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Pages (from-to) | 929-939 |
Number of pages | 11 |
Journal | Pediatric Nephrology |
Volume | 39 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2024 |
Funding
The ADQI 26 workgroup: The following individuals contributed to the formulation and content of this work in accordance with their participation in the 26th Acute Disease Quality Initiative (ADQI XXVI). Chairs: Ayse Akcan Arikan, MD, Baylor College of Medicine, Department of Pediatrics, Divisions of Critical Care Medicine and Nephrology, Houston, TX, USA. Rajit K. Basu, MD, MS, Northwestern University Feinberg School of Medicine, Ann & Robert Lurie Children’s Hospital of Chicago, Department of Pediatrics, Division of Critical Care Medicine, Chicago, IL, USA. Stuart L. Goldstein, MD, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, Division of Nephrology & Hypertension, Cincinnati, OH, USA. Rashid Alobaidi1, David J. Askenazi2, Sean M. Bagshaw1, Matthew Barhight3, Erin Barreto4, Benan Bayrakci5, O.N. Ray Bignall II6, Erica Bjornstad2, Patrick Brophy7, Jennifer Charlton8, Rahul Chanchlani9, Andrea L. Conroy10, Akash Deep11, Prasad Devarajan12, Kristin Dolan13, Dana Fuhrman14, Katja M. Gist12, Stephen M. Gorga15, Jason H. Greenberg16, Denise Hasson12, Emma Heydari1, Arpana Iyengar17, Jennifer Jetton18, Catherine Krawczeski6, Leslie Meigs19, Shina Menon20, Catherine Morgan1, Jolyn Morgan12, Theresa Mottes3, Tara Neumayr21, Zaccaria Ricci22, David T. Selewski23, Danielle Soranno10, Natalja Stanski12, Michelle Starr10, Scott M. Sutherland24, Jordan Symons20, Marcelo Tavares25, Molly Vega26, Michael Zappitelli27, Claudio Ronco28, Ravindra L. Mehta29, John Kellum30, and Marlies Ostermann31.1Alberta Health Sciences University, Edmonton, Alberta, Canada.2University of Alabama at Birmingham, Children’s Hospital of Alabama, Birmingham, AL, USA.3Northwestern University Feinberg School of Medicine, Ann & Robert Lurie Children’s Hospital of Chicago, Chicago, IL, USA.4Hacettepe University, Ankara, Türkiye5Mayo Clinic, Rochester, MN, USA.6Nationwide Children’s Hospital, Ohio State University, Columbus, OH, USA.7Golisano Children’s Hospital, Rochester University Medical Center, Rochester, NY, USA.8University of Virginia, Charlottesville, VA, USA.9McMaster University, McMaster Children’s Hospital, Hamilton, ON, Canada.10Riley Children’s Hospital, Indiana University School of Medicine, Indianapolis, IN, USA.11King’s College London, King’s College Hospital NHS Foundation Trust, London, UK12Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA.13Mercy Children’s Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.14Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.15C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA.16Yale University Medical Center, New Haven, CT, USA.17St. John’s National Academy of Health Sciences, Bangalore, India.18Stead Family Children’s Hospital, University of Iowa, Iowa City, IA, USA.19University of St. Thomas, Houston, TX USA.20Seattle Children’s Hospital, University of Washington, Seattle, WA, USA.21Washington University School of Medicine, St. Louis, MO, USA.22University of Florence, Florence, Italy.23Medical University of South Carolina, Charleston, SC, USA.24Lucille Packard Children’s Hospital, Stanford University, Palo Alto, CA, USA.25Santa Casa dela Belo Horizonte, Belo Horizonte, Brazil.26Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA.27Hospital for Sick Children, Toronto, Ontario, Canada.28San Bartolo Hospital, Universiti di Padova, Vicenza, Italy.29University of California San Diego School of Medicine, La Jolla, CA, USA.30University of Pittsburgh Medical Center, Pittsburgh, PA, USA.31Guy’s and St. Thomas’ NHS Foundation Trust, London, UK.
Keywords
- Acute kidney injury
- Biomarkers
- Diagnosis
- Pediatrics
- Phenotypes
- Precision medicine
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Nephrology