Childhood acute kidney injury in icu raises risk of chronic kidney disease


Childhood acute kidney injury in icu raises risk of chronic kidney disease

According to a study published in the April issue of the American Journal of Kidney Diseases, children are more likely to develop chronic kidney disease (CKD) if they have suffered and recovered from acute kidney injury (AKI) in an intensive care unit (ICU).

The researchers examined 126 children with AKI below the age of 18 years. AKI is a rapid loss of kidney function that can develop in the ICU as a result of treatment complications or severe illness. To determine the number of children who developed CKD, the authors assessed the patients at 1 to 3 years after they suffered AKI.

Lead author of the study, Dr. Cherry Mammen, of British Columbia Children's Hospital in Vancouver, Canada, explained:

"The long-term implications of a single episode of acute kidney injury on overall kidney health has been well studied in critically-ill adult patients, but not in children."

In children admitted to the ICU, AKI is primarily caused through lack of oxygen and blood flow to the kidneys. AKI may occur from various medications, severe infections (sepsis) and from major operations, including cardiac surgery.

The researchers found that around 10% of children who had AKI in the ICU developed chronic kidney disease, as defined by reduced kidney function from blood tests and/or protein in the urine. Furthermore, results indicated that 47% of children in the study were at risk of developing CKD with findings such as high blood pressure and mildly reduced kidney function.

Dr. Mammen, said:

"As pediatric ICU populations are growing and more are surviving due to advances in ICU care, it is important to identify AKI as a possible risk factor for future development of CDK.

Acute Kidney injury is a common event in the ICU setting. Currently, many of these kids who suffer from AKI are not followed by a nephrologist, or kidney specialist, and in general are not monitored for their kidney health long term."

According to Dr. Mammen, the study has paved the way for additional studies on AKI, including determining the best methods for measuring kidney injury in neonates, infants undergoing cardiac surgery, as well as other high risk populations.

Dr. Kerry Willis, National Kidney Foundation Senior Vice President of Scientific and Medical Activities, explained:

"The study's findings indicate the importance of children receiving follow-up care with a nephrologist, or a physician who will be able to monitor kidney function after AKI.

It could be as simple as an annual urinalysis and blood pressure check...Of you catch CDK early in a child, you may be able to treat it or slow its progression."

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