Early prediction of acute kidney injury in children: known biomarkers but novel combination

Excerpt

Acute kidney injury (AKI) is a global public health concern with rapid decline in glomerular filtration rate and significant increase in serum creatinine and blood urea nitrogen, which is an independent risk factor for short-term and long-term mortality [1, 2]. In addition to kidney disease, AKI can occur secondary to a variety of diseases, such as multi-organ dysfunction, respiratory distress syndrome, sepsis, losing of gastrointestinal fluids, cardiac surgery, using of nephrotoxic drugs and tumors. The most common causes for AKI of children include sepsis, ischemia and reperfusion injury and tubulointerstitial lesions [3]. Additionally, morbidity and mortality were high in critically ill patients, especially for those who were admitted to pediatric intensive care unit (PICU) and underwent cardiac surgery [2‐4]. Although renal replacement therapies have greatly improved and can provide relief for most patients, the mortality remained high for critically ill children as high as 10%, about six times higher than non-AKI patients [2]. In the past few years, studies have reported that even mild elevation of serum creatinine levels may increase the risk of complications and mortality [5]. In a prospective cohort study, 10.3% of survivors from AKI in the PICU eventually progress to chronic kidney disease [6]. …