Acute kidney injury in childhood: should we be worried  about progression to CKD?

Acute kidney injury in childhood: should we be worried about progression to CKD?

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Stuart L. Goldstein & Prasad Devarajan
  • چاپ و سال / کشور: 2011

Description

While emerging evidence indicates that the incidence of both acute kidney injury (AKI) and chronic kidney disease (CKD) in children is rising and that the etiologies are dramatically changing, relatively little is currently known regarding the potential for transition from AKI to CKD. Major barriers to assessing for a potential AKI to CKD link have included lack of a standard pediatric AKI definition, narrow focus only on children with AKI who receive renal replacement therapy, and reliance on serum creatinine as the main biomarker to detect and diagnose AKI and CKD. Recent data have validated a multi-dimensional AKI classification system for children and have suggested chronic kidney sequelae in pediatric populations with AKI or at risk for AKI. In addition, a number of novel AKI biomarkers are being rigorously validated as early indicators of incipient CKD. Our goals for this article are to (1) review the recent changes in pediatric AKI and CKD epidemiology, (2) explore the evidence for a potential AKI to CKD link, and (3) propose new clinical and research paradigms to better elucidate the progression from AKI to CKD.
Pediatr Nephrol (2011) 26:509–522 DOI 10.1007/s00467-010-1653-4 Received: 17 July 2010 / Revised: 19 August 2010 / Accepted: 24 August 2010 / Published online: 10 October 2010
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