Abstract
Acute kidney injury (AKI) is a significant problem for critically ill children. The kidney is responsible for numerous homeostatic controls in the body and disruption of kidney function carries significant and severe consequence for the host. Unfortunately, poor understanding of the multifactorial nature of the causes of AKI and the inability to accurately diagnose real-time injury impedes the derivation of any universally accepted therapy for kidney injury. The list of causes of AKI in pediatrics is long, but most etiologies share commonalities in how they induce injury. Recent consensus definitions of AKI have allowed for more stratified and tiered injury levels, improving epidemiologic study of the impact of AKI. Biomarker research continues to pursue the optimal marker, or collection of markers, for prediction of AKI, diagnosis of established AKI, and the ability to predict progression or recovery from AKI. Unfortunately, complete recovery from AKI in the critically ill patient is likely more an assumption than the reality. Many patients transition to chronic kidney disease (CKD) months to years after recovering from AKI. As nephrologists and intensivists understand that more patients are dying from AKI and not just with AKI, attention has been focused on efforts to prevent AKI in the at-risk patient and supportive care for those afflicted with injury. This chapter will discuss the pathophysiology, diagnosis, epidemiology, and management of AKI in pediatrics and the horizon for the optimal care of children at-risk and recovering from this lethal disease process.
Original language | English (US) |
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Title of host publication | Gastroenterological, Endocrine, Renal, Hematologic, Oncologic and Immune Systems |
Publisher | Springer-Verlag London Ltd |
Pages | 191-212 |
Number of pages | 22 |
Volume | 3 |
ISBN (Electronic) | 9781447164166 |
ISBN (Print) | 1447164156, 9781447164159 |
DOIs | |
State | Published - Feb 1 2014 |
Keywords
- AKI biomarkers
- AKI epidemiology
- AKI management
- AKI pathophysiology
- Acute kidney injury
- KDIGO
- Renal angina
ASJC Scopus subject areas
- General Medicine