The Neglected Price of Pediatric Acute Kidney Injury: Non-renal Implications

Frontiers in Pediatrics

article

Chetna K. Pande¹  Mallory B. Smith²  Danielle E. Soranno⁴  Katja M. Gist⁵  Dana Y. Fuhrman⁶  Kristin Dolan⁸  Andrea L. Conroy⁹  Ayse Akcan-Arikan¹ 

[1] Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital;Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington;Harborview Injury Prevention and Research Center, University of Washington;Section of Nephrology, Departments of Pediatrics, Bioengineering and Medicine, University of Colorado;Division of Cardiology, Department of Pediatrics, Cioncinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati;Division of Critical Care Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh;Division of Nephrology, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh;Division of Critical Care Medicine, Department of Pediatrics, University of Missouri Kansas City, Children's Mercy Hospital;Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine;Division of Nephrology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital

关键词: acute kidney injury;    pediatric critical care medicine;    acute lung injury;    cardiac dysfunction;    functional status;    growth;    neurologic injury;    immunoparalysis;   

DOI  :  10.3389/fped.2022.893993

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.

【 授权许可】

CC BY