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Acute Kidney Injury: Pathophysiology, Diagnosis and Prevention

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Pediatric Kidney Disease

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Abstract

Acute kidney injury (AKI) is an increasingly common problem afflicting all ages, occurring in 10–30% of non-critically ill hospitalized children and >30% of children in critical care units. AKI is the leading reason to seek in-patient nephrology consultation and associated with serious short-term and long-term consequences, and therapeutic options are unsatisfactory. The etiology of AKI varies widely according to age, geographical region, and clinical setting. Functional AKI induced by dehydration is usually reversible with early fluid therapy. However, the prognosis for patients with structural AKI in the setting of critical illness remains guarded. Recent clinical advances have highlighted the definitions, epidemiology, and roles of fluid overload and continuous kidney support therapies in human AKI. Additionally, newly discovered pathogenetic pathways are yielding novel early biomarkers for the prediction of AKI and its consequences, as well as innovative strategies for the pro-active treatment and prevention of AKI. A judicious combination of clinical judgment, established functional markers, novel structural markers, and technical advances in therapies holds the greatest promise for progress in human intrinsic AKI. This chapter will focus on recent advances in the definitions, epidemiology, pathophysiology, diagnosis, prevention, and outcomes of pediatric AKI.

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  1. Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Prasad Devarajan

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  1. Division of Pediatric Nephrology, Heidelberg University, Heidelberg, Germany

    Franz Schaefer

  2. Emory School of Medicine, Emory University, Atlanta, GA, USA

    Larry A. Greenbaum

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Devarajan, P. (2023). Acute Kidney Injury: Pathophysiology, Diagnosis and Prevention. In: Schaefer, F., Greenbaum, L.A. (eds) Pediatric Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-031-11665-0_51

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