| [ Summary ] |
The KDIGO criteria are used for diagnosis and classification of acute kidney injury (AKI) in children. The prevalence of AKI in children is about 33 % of all inpatients, particularly in pediatric intensive care units. Secondary AKI, caused by extrarenal disease, accounts for 2/3 of the indications for renal replacement therapy. Although the mortality rate is high in secondary AKI, the renal outcomes are satisfactory in survivors. Various biomarkers, including NGAL (neutrophil gelatiase-associated lipocain), have been studied for early diagnosis of pediatric AKI. In the 2017 AKI guidelines, the use of biomarkers is not clearly recommended for pediatric AKI. Blood fluid management is particularly important as supportive therapy for AKI, avoiding an excess of body fluid volume by appropriate infusion and diuretics management. In cases where symptoms of AKI are not controlled by conservative treatment, renal replacement therapy is introduced. In recent years, due to technical advances, hemodialysis can be safely performed, even in childhood and the neonatal period. Appropriate blood purification therapy is selected considering the patient's status. |