Pediatric acute kidney injury and the subsequent risk for chronic kidney disease: is there cause for alarm?

Vaka K. Sigurjonsdottir, Swasti Chaturvedi, Cherry Mammen, Scott M. Sutherland

    Research output: Contribution to journalArticle

    Abstract

    Acute kidney injury (AKI) is characterized clinically as an abrupt decline in renal function marked by reduced excretion of waste products, disordered electrolytes, and disrupted fluid homeostasis. The recent development of a standardized AKI definition has transformed our understanding of AKI epidemiology and outcomes. We now know that in the short term, children with AKI experience greater morbidity and mortality; additionally, observational studies have established that chronic renal sequelae are far more common after AKI events than previously realized. Many of these studies suggest that patients who develop AKI are at greater risk for the subsequent development of chronic kidney disease (CKD). The goal of this review is to critically evaluate the data regarding the association between AKI and CKD in children. Additionally, we describe best practice approaches for future studies, including the use of consensus AKI criteria, the application of rigorous definitions for CKD and renal sequelae, and the inclusion of non-AKI comparator groups. Finally, based upon existing data, we suggest an archetypal approach to follow-up care for the AKI survivors who may be at greater CKD risk, including children with more severe AKI, those who endure repeated AKI episodes, patients who do not experience full recovery, and those with pre-existing CKD.

    Original languageEnglish
    Pages (from-to)2047-2055
    Number of pages9
    JournalPediatric Nephrology
    Volume33
    Issue number11
    Early online date26 Jan 2018
    DOIs
    Publication statusPublished - Nov 2018

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