Long-term Risk of CKD in Children Surviving Episodes of Acute Kidney Injury in the Intensive Care Unit: A Prospective Cohort Study

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

“…In addition, several adult studies have demonstrated a dose-response relationship between AKI and CKD, including a higher risk of CKD in those with more severe AKI and also in those with repeated episodes of AKI [35][36][37]. Several pediatric observational studies have also shown a high proportion of CKD in survivors of AKI, ranging from 10 to 69%, but these studies have focused on populations without primary kidney disease [38][39][40][41][42][43][44]. Although the etiology of AKI varies in most of these studies, Menon and colleagues identified that nephrotoxic AKI in children increases the risk of CKD at 6 months of follow-up [44].…”

Acute kidney injury after pediatric cardiac surgery: Risk factors and outcomes. Proposal for a predictive model

“…Akcan-Arikan et al demonstrated in a pediatric population that classification of AKI based on variation in GFR was not altered significantly by the addition of urine output as a criterion, 7 while Mammen et al showed that changes in serum creatinine are more sensitive than urine output for identifying AKI. 4 The etiology of AKI in the context of cardiopulmonary bypass is related to hypoperfusion, inflammation and loss of pulsatile flow, leading to vasoconstriction and ischemia. The findings of the present study support this line of thinking, revealing a greater incidence of AKI in patients with a higher Aristotle score and longer bypass time.…”

“…3 Retrospective studies suggest that AKI associated with cardiac surgery may affect not only short-term outcomes but also the risk of developing chronic renal failure. 4 A thorough understanding of its pathophysiology and associated risk factors is therefore necessary to reduce the incidence of AKI in these patients.…”

Strategies to improve the understanding of long-term renal consequences after neonatal acute kidney injury

“…Research over the past decade has provided substantial data showing that AKI leads to CKD (2)(3)(4)(5)(6)(7)(8). Although the exact mechanisms underlying the progression from AKI to CKD continue to be explored, endothelial damage may play a critical role in outcomes, leading to nephron drop-out, interstitial fibrosis, and, ultimately, CKD (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”

“…Premature infants and critically ill neonates are at risk for chronic kidney disease (CKD), yet the exact pathophysiology, incidence, risk factors, and outcomes are not yet known. Acute kidney injury (AKI) has emerged as a risk factor for future CKD in both pediatric (2,3) and adult observational studies (4,5). Animal models have begun to identify the pathophysiologic mechanisms that lead to the development of CKD after episodes of AKI (5)(6)(7)(8).…”