BACKGROUND: Acute kidney injury (AKI) in children is a serious condition with an important impact on morbidity and mortality. Onset can be insidious and it is frequently unrecognized in the early phase when the therapeutic opportunities are theoretically more effective. SUMMARY: The present review focuses on the most recent epidemiology studies and the progress in pediatric AKI (pAKI) research. Standardization of definition (presented in the Kidney Disease: Improving Global Outcomes) and novel biomarkers have been developed to help clinicians recognize kidney injury in a timely manner, both in adult and pediatric populations. Strengths and weaknesses of these diagnostic tools are discussed and the clinical scoring system (Renal Angina Index), which aims to provide a rational context for biomarker utilization, is also presented. Even if effective treatments are not currently available for established AKI, specific preventive approaches and some promising pharmacological treatments will be detailed. Renal replacement therapy is currently considered the most effective way to manage fluid balance when severe AKI occurs. Key Messages: Great efforts in pAKI research have today led to new strategies for early AKI detection and prevention strategies. Further studies have to be conducted in the next future in order to definitely improve the outcomes of pediatric patients experiencing this deadly syndrome.
BACKGROUND:Acute kidney injury (AKI) in children is a serious condition with an important impact on morbidity and mortality. Onset can be insidious and it is frequently unrecognized in the early phase when the therapeutic opportunities are theoretically more effective. SUMMARY: The present review focuses on the most recent epidemiology studies and the progress in pediatric AKI (pAKI) research. Standardization of definition (presented in the Kidney Disease: Improving Global Outcomes) and novel biomarkers have been developed to help clinicians recognize kidney injury in a timely manner, both in adult and pediatric populations. Strengths and weaknesses of these diagnostic tools are discussed and the clinical scoring system (Renal Angina Index), which aims to provide a rational context for biomarker utilization, is also presented. Even if effective treatments are not currently available for established AKI, specific preventive approaches and some promising pharmacological treatments will be detailed. Renal replacement therapy is currently considered the most effective way to manage fluid balance when severe AKI occurs. Key Messages: Great efforts in pAKI research have today led to new strategies for early AKI detection and prevention strategies. Further studies have to be conducted in the next future in order to definitely improve the outcomes of pediatric patients experiencing this deadly syndrome.
Authors: Dristhi Ragoonanan; Sajad J Khazal; Hisham Abdel-Azim; David McCall; Branko Cuglievan; Francesco Paolo Tambaro; Ali Haider Ahmad; Courtney M Rowan; Cristina Gutierrez; Keri Schadler; Shulin Li; Matteo Di Nardo; Linda Chi; Alison M Gulbis; Basirat Shoberu; Maria E Mireles; Jennifer McArthur; Neena Kapoor; Jeffrey Miller; Julie C Fitzgerald; Priti Tewari; Demetrios Petropoulos; Jonathan B Gill; Christine N Duncan; Leslie E Lehmann; Sangeeta Hingorani; Joseph R Angelo; Rita D Swinford; Marie E Steiner; Fiorela N Hernandez Tejada; Paul L Martin; Jeffery Auletta; Sung Won Choi; Rajinder Bajwa; Natalie Dailey Garnes; Partow Kebriaei; Katayoun Rezvani; William G Wierda; Sattva S Neelapu; Elizabeth J Shpall; Selim Corbacioglu; Kris M Mahadeo Journal: Nat Rev Clin Oncol Date: 2021-02-19 Impact factor: 65.011
Authors: Francisco Ribeiro-Mourão; Ana Carvalho Vaz; André Azevedo; Helena Pinto; Marta João Silva; Joana Jardim; Augusto Ribeiro Journal: Pediatr Nephrol Date: 2021-06-08 Impact factor: 3.714