Acute Kidney Injury in Children: A Focus for the General Pediatrician
Giulio Rivetti,
Pietro Gizzone,
Delfina Petrone,
Anna Di Sessa,
Emanuele Miraglia del Giudice,
Stefano Guarino,
Pierluigi Marzuillo
Affiliations
Giulio Rivetti
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 2, 80138 Naples, Italy
Pietro Gizzone
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 2, 80138 Naples, Italy
Delfina Petrone
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 2, 80138 Naples, Italy
Anna Di Sessa
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 2, 80138 Naples, Italy
Emanuele Miraglia del Giudice
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 2, 80138 Naples, Italy
Stefano Guarino
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 2, 80138 Naples, Italy
Pierluigi Marzuillo
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 2, 80138 Naples, Italy
Acute kidney injury (AKI) presents significant challenges in pediatric care, often remaining underrecognized. This paper provides an overview of pediatric AKI, highlighting its epidemiology, pathophysiology, diagnosis, predisposing conditions, and treatment. AKI in children stems from diverse causes, including renal tubular damage, vasoconstriction, and inflammation. Diagnosis relies on traditional markers such as serum creatinine and urine output, alongside emerging biomarkers such as Cystatin C, NGAL, KIM-1, IL-18, TIMP-2 and IGFBP7, urinary calprotectin, URBP4, L-FABP, and clusterin. Various pediatric conditions predispose to AKI, including type 1 diabetes, pneumonia, bronchiolitis, appendicitis, gastroenteritis, COVID-19, multisystem inflammatory syndrome, sickle cell disease, and malignancies. Treatment entails supportive care with fluid management and, in severe cases, renal replacement therapy. Timely recognition and management are essential to mitigating adverse outcomes. Enhanced awareness and integration of novel biomarkers could improve pediatric AKI care, warranting further research for better diagnosis and management.
