Acute Kidney Injury in Critically Ill Children Is Not all Acute: Lessons Over the Last 5 Years

Frontiers in Pediatrics

Sean M. Bagshaw¹  Nabil Melhem²  Manish D. Sinha³  Catherine Morgan⁴  Emma Ulrich⁴  Rashid Alobaidi⁵  Erin Hessey⁶ 

[1] Department of Critical Care Medicine, Faculty of Medicine and Dentistry and Alberta Health Services—Edmonton Zone, University of Alberta, Edmonton, AB, Canada;Alberta Critical Care Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada;Department of Pediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom;Department of Pediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom;King's College London, London, United Kingdom;Department of Pediatric Nephrology, Stollery Children's Hospital, Edmonton, AB, Canada;Division of Pediatric Critical Care, Department of Pediatrics, University of Alberta and Stollery Children's Hospital, Edmonton, AB, Canada;Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada;

关键词: acute kideny injury;    chronic kidney disease;    long-term follow up;    hypertension;    healthcare utilization;    mortality;    critical care;   

DOI  :  10.3389/fped.2021.648587

来源: Frontiers

【 摘 要 】

Acute kidney injury (AKI) in the pediatric intensive care unit (PICU) is an important risk factor for increased morbidity and mortality during hospitalization. Over the past decade, accumulated data on children and young people indicates that acute episodes of kidney dysfunction can have lasting consequences on multiple organ systems and health outcomes. To date, there are no guidelines for follow-up of surviving children that may be at risk of long-term sequelae following AKI in the PICU. This narrative review aims to describe literature from the last 5 years on the risk of medium and long-term kidney and non-kidney outcomes after AKI in the PICU. More specifically, we will focus on outcomes in children and young people following AKI in the general PICU population and children undergoing cardiac surgery. These outcomes include mortality, hypertension, proteinuria, chronic kidney disease, and healthcare utilization. We also aim to highlight current gaps in knowledge in medium and long-term outcomes in this pediatric population. We suggest a framework for future research to develop evidence-based guidelines for follow-up of children surviving an episode of critical illness and AKI.

【 授权许可】

CC BY