While emerging evidence indicates that the incidence of both acute kidney injury (AKI) and chronic kidney disease (CKD) in children is rising, and the etiologies are dramatically changing, relatively little is currently known regarding the potential for transition from AKI to CKD. In both situations, early intervention can significantly improve the dismal prognosis. Fortunately, recent data have validated a multidimensional AKI classification system for children, and led to the investigation of the chronic kidney sequelae in many pediatric populations with AKI, or at risk for AKI (children with hemolytic uremic syndrome, neonates or those exposed to repeated nephrotoxic medications). The purpose of this article is to review the changing epidemiology of pediatric AKI and its potential effect on the development of CKD in children.

Keywords:
Acute kidney injury, Chronic kidney disease, Pediatrics
1.
McDonald SP, Craig JC: Long-term survival of children with end-stage renal disease. N Engl J Med 2004;350:2654–2662.
2.
Chavers BM, Li S, Collins AJ, Herzog CA: Cardiovascular disease in pediatric chronic dialysis patients. Kidney Int 2002;62:648–653.
3.
Symons JM, et al: Demographic characteristics of pediatric continuous renal replacement therapy: a report of the prospective pediatric continuous renal replacement therapy registry. Clin J Am Soc Nephrol 2007;2:732–738.
4.
Hui-Stickle S, Brewer ED, Goldstein SL: Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001. Am J Kidney Dis 2005;45:96–101.
5.
Collins AJ, et al: United States Renal Data System 2008 Annual Data Report. Am J Kidney Dis 2009;53:S1–S374.
6.
Andreoli SP: Acute renal failure. Curr Opin Pediatr 2002;14:183–188.
7.
Flynn JT: Choice of dialysis modality for management of pediatric acute renal failure. Pediatr Nephrol 2002;17:61–69.
8.
Williams DM, Sreedhar SS, Mickell JJ, Chan JC: Acute kidney failure: a pediatric experience over 20 years. Arch Pediatr Adolesc Med 2002;156:893–900.
9.
Vachvanichsanong P, Dissaneewate P, Lim A, McNeil E: Childhood acute renal failure: 22-year experience in a university hospital in southern Thailand. Pediatrics 2006;118:e786–e791.
10.
Ball EF, Kara T: Epidemiology and outcome of acute kidney injury in New Zealand children. J Paediatr Child Health 2008;44:642–646.
11.
Warady BA, Bunchman T: Dialysis therapy for children with acute renal failure: survey results. Pediatr Nephrol 2000;15:11–13.
12.
Bailey D, et al: Risk factors of acute renal failure in critically ill children: a prospective descriptive epidemiological study. Pediatr Crit Care Med 2007;8:29–35.
13.
Mishra J, et al: Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet 2005;365:1231–1238.
14.
Dent CL, et al: Plasma neutrophil gelatinase-associated lipocalin predicts acute kidney injury, morbidity and mortality after pediatric cardiac surgery: a prospective uncontrolled cohort study. Crit Care 2007;11:R127.
15.
Bennett M, et al: Urine NGAL predicts severity of acute kidney injury after cardiac surgery: a prospective study. Clin J Am Soc Nephrol 2008;3:665–673.
16.
Kellum JA, Angus DC: Patients are dying of acute renal failure. Crit Care Med 2002;30:2156–2157.
17.
Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW: Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 2005;16:3365–3370.
18.
Price JF, et al: Worsening renal function in children hospitalized with decompensated heart failure: evidence for a pediatric cardiorenal syndrome? Pediatr Crit Care Med 2008;9:279–284.
19.
Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P: Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:R204–R212.
20.
Akcan-Arikan A, et al: Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 2007;71:1028–1035.
21.
Hoste EA, Kellum JA: RIFLE criteria provide robust assessment of kidney dysfunction and correlate with hospital mortality. Crit Care Med 2006;34:2016–2017.
22.
Srisawat N, Hoste EE, Kellum JA: Modern classification of acute kidney injury. Blood Purif 2010;29:300–307.
23.
Plotz FB, Bouma AB, van Wijk JA, Kneyber MC, Bokenkamp A: Pediatric acute kidney injury in the ICU: an independent evaluation of pRIFLE criteria. Intensive Care Med 2008;34:1713–1717.
24.
Palmieri T, Lavrentieva A, Greenhalgh D: An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns. Intensive Care Med 2009;35:2125–2129.
25.
Zappitelli M, et al: Ascertainment and epidemiology of acute kidney injury varies with definition interpretation. Clin J Am Soc Nephrol 2008;3:948–954.
26.
Zappitelli M, et al: Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study. Crit Care 2007;11:R84.
27.
Washburn KK, et al: Urinary interleukin-18 is an acute kidney injury biomarker in critically ill children. Nephrol Dial Transplant 2008;23:566–572.
28.
Mehta RL, et al: Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:R31.
29.
Zappitelli M, Moffett BS, Hyder A, Goldstein SL: Acute kidney injury in non-critically ill children treated with aminoglycoside antibiotics in a tertiary healthcare centre: a retrospective cohort study. Nephrol Dial Transplant 2011;26:144–150.
30.
Goldstein SL, Chawla LS: Renal angina. Clin J Am Soc Nephrol 2010;5:943–949.
31.
D’Amico G: Comparability of the different registries on renal replacement therapy. Am J Kidney Dis 1995;25:113–118.
32.
Neu AM, Ho PL, McDonald RA, Warady BA: Chronic dialysis in children and adolescents. The 2001 NAPRTCS Annual Report. Pediatr Nephrol 2002;17:656–663.
33.
Furth SL, et al: Design and methods in the Chronic Kidney Disease in Children (CKiD) prospective cohort study. Clin J Am Soc Neph 2006;1:1005–1015.
34.
Schwartz GJ, Brion LP, Spitzer A: The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 1987;34:571–590.
35.
Schwartz GJ, et al: New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20:629–637.
36.
Zappitelli M, Joseph L, Gupta IR, Bell L, Paradis G: Validation of child serum creatinine-based prediction equations for glomerular filtration rate. Pediatr Nephrol 2007;22:272–281.
37.
Zappitelli M, et al: Derivation and validation of cystatin C-based prediction equations for GFR in children. Am J Kidney Dis 2006;48:221–230.
38.
Mitsnefes MM, et al: Serum neutrophil gelatinase-associated lipocalin as a marker of renal function in children with chronic kidney disease. Pediatr Nephrol 2007;22:101–108.
39.
Nickolas TL, Barasch J, Devarajan P: Biomarkers in acute and chronic kidney disease. Curr Opin Nephrol Hypertens 2008;17:127–132.
40.
Wheeler DS, et al: Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock. Crit Care Med 2008;36:1297–1303.
41.
Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A: Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis 2009;54:1012–1024.
42.
Askenazi DJ, Feig DI, Graham NM, Hui-Stickle S, Goldstein SL: 3–5 year longitudinal follow-up of pediatric patients after acute renal failure. Kidney Int 2006;69:184–189.
43.
Garg AX, et al: Long-term renal prognosis of diarrhea-associated hemolytic uremic syndrome: a systematic review, meta-analysis, and meta-regression. JAMA 2003;290:1360–1370.
44.
White SL, et al: Is low birth weight an antecedent of CKD in later life? A systematic review of observational studies. Am J Kidney Dis 2009;54:248–261.
45.
Michael M, Kuehnle I, Goldstein SL: Fluid overload and acute renal failure in pediatric stem cell transplant patients. Pediatr Nephrol 2004;19:91–95.
46.
Kist-van Holthe JE, et al: Prospective study of renal insufficiency after bone marrow transplantation. Pediatr Nephrol 2002;17:1032–1037.
47.
Hingorani S, Guthrie KA, Schoch G, Weiss NS, McDonald GB: Chronic kidney disease in long-term survivors of hematopoietic cell transplant. Bone Marrow Transplant 2007;39:223–229.
48.
Van Why SK, Friedman AL, Wei LJ, Hong R: Renal insufficiency after bone marrow transplantation in children. Bone Marrow Transplant 1991;7:383–388.
49.
Gronroos MH, Bolme P, Winiarski J, Berg UB: Long-term renal function following bone marrow transplantation. Bone Marrow Transplant 2007;39:717–723.
50.
Frisk P, Bratteby LE, Carlson K, Lonnerholm G: Renal function after autologous bone marrow transplantation in children: a long-term prospective study. Bone Marrow Transplant 2002;29:129–136.
51.
Jones DP, Spunt SL, Green D, Springate JE: Renal late effects in patients treated for cancer in childhood: a report from the Children’s Oncology Group. Pediatr Blood Cancer 2008;51:724–731.
52.
Arjmandi-Rafsanjani K, Hooman N, Vosoug P: Renal function in late survivors of Iranian children with cancer: single centre experience. Indian J Cancer 2008;45:154–157.
53.
Jetton JG, Ocku F, Dreyer ZE, Goldstein SL: Pediatric cancer survivors are at high risk for CKD. J Am Soc Nephrol 2009;20:748A.
© 2012 S. Karger AG, Basel
2012
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.