TY - JOUR
T1 - Controversies in paediatric acute kidney injury and continuous renal replacement therapy
T2 - can paediatric care lead the way to precision acute kidney injury medicine?
AU - Stanski, Natalja L.
AU - Fuhrman, Dana
AU - Basu, Rajit K.
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Purpose of reviewPaediatric patients represent a unique challenge for providers managing acute kidney injury (AKI). Critical care for these children requires a precise approach to assessment, diagnostics and management.Recent findingsPrimarily based on observational data, large epidemiologic datasets have demonstrated a strong association between AKI prevalence (one in four critically ill children) and poor patient outcome. Drivers of AKI itself are multifactorial and the causal links between AKI and host injury remain incompletely defined, creating a management paradigm primarily supportive in nature. The previous decades of research have focused primarily on elucidating the population-level epidemiologic signal of AKI and use of renal replacement therapy (RRT), but in order to reverse the course of the AKI 'epidemic', future decades will require more attention to the individual patient. A patient-level approach to AKI in children will require sophisticated approaches to risk stratification, diagnostics and targeted utilization of therapies (both supportive and targeted towards drivers of injury).SummaryIn this review, we will summarize the past, present and future of AKI care in children, discussing the ongoing work and future goals of a personalized approach to AKI medicine.
AB - Purpose of reviewPaediatric patients represent a unique challenge for providers managing acute kidney injury (AKI). Critical care for these children requires a precise approach to assessment, diagnostics and management.Recent findingsPrimarily based on observational data, large epidemiologic datasets have demonstrated a strong association between AKI prevalence (one in four critically ill children) and poor patient outcome. Drivers of AKI itself are multifactorial and the causal links between AKI and host injury remain incompletely defined, creating a management paradigm primarily supportive in nature. The previous decades of research have focused primarily on elucidating the population-level epidemiologic signal of AKI and use of renal replacement therapy (RRT), but in order to reverse the course of the AKI 'epidemic', future decades will require more attention to the individual patient. A patient-level approach to AKI in children will require sophisticated approaches to risk stratification, diagnostics and targeted utilization of therapies (both supportive and targeted towards drivers of injury).SummaryIn this review, we will summarize the past, present and future of AKI care in children, discussing the ongoing work and future goals of a personalized approach to AKI medicine.
KW - biomarker enrichment
KW - continuous renal replacement therapy
KW - opportunities
KW - paediatric critical care medicine
KW - precision medicine
KW - strengths
KW - threats
KW - weaknesses
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U2 - 10.1097/MCC.0000000000000888
DO - 10.1097/MCC.0000000000000888
M3 - Review article
C2 - 34561357
AN - SCOPUS:85121954866
SN - 1070-5295
VL - 27
SP - 604
EP - 610
JO - Current opinion in critical care
JF - Current opinion in critical care
IS - 6
ER -