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Review
Recent developments in the detection and management of acute kidney injury
  1. James McCaffrey1,
  2. Ajaya Kumar Dhakal1,2,
  3. David V Milford3,
  4. Nicholas J A Webb1,
  5. Rachel Lennon1,4
  1. 1Department of Paediatric Nephrology, Central Manchester University Hospitals NHS Foundation Trust (CMFT), Manchester Academic Health Science Centre (MAHSC), Manchester, UK
  2. 2KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal
  3. 3Department of Nephrology, Birmingham Children's Hospital, Birmingham, UK
  4. 4Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, Manchester, UK
  1. Correspondence to Dr Rachel Lennon, Department of Paediatric Nephrology, Royal Manchester Children's Hospital, Manchester M13 9WL, UK; Rachel.Lennon{at}manchester.ac.uk

Abstract

Acute kidney injury (AKI) is a common condition in children admitted to hospital and existing serum and urine biomarkers are insensitive. There have been significant developments in stratifying the risk of AKI in children and also in the identification of new AKI biomarkers. Risk stratification coupled with a panel of AKI biomarkers will improve future detection of AKI, however, paediatric validation studies in mixed patient cohorts are required. The principles of effective management rely on treating the underlying cause and preventing secondary AKI by the appropriate use of fluids and medication. Further therapeutic innovation will depend on improving our understanding of the basic mechanisms underlying AKI in children.

  • Acute kidney injury
  • Biomarker
  • Stratification

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

http://dx.doi.org/10.1136/archdischild-2015-309381

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    Footnotes

    • Twitter Follow Rachel Lennon at @RLWczyk

    • Contributors JM, AKD, DVM, NJAW and RL researched and prepared the manuscript.

    • Funding JM was supported the North West England Medical Research Council Fellowship Scheme in Clinical Pharmacology and Therapeutics (ref: G1000417/94909). AKD is a clinical fellow supported by the International Society of Nephrology (ISN) and Kidneys for Life in the ISN fellowship programme. NJAW is Director of the NIHR/Wellcome Trust Manchester Clinical Research Facility and is part-funded by the NIHR. RL is a Wellcome Trust Intermediate Clinical Fellow (ref: 090006).

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.

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