Skip to main content

Acute Kidney Injury

  • Chapter
  • First Online:
Fundamentals of Pediatric Surgery

Abstract

Any process that interferes with the architecture and function of the renal vascular supply, the glomeruli, the renal tubule, or the urinary tract can compromise renal function. Acute kidney injury (AKI) can be defined as the sudden loss of renal function measured by a decline in GFR that develops over hours to days as a result of decreased renal perfusion, renal cell injury, or obstruction to urine outflow. The term AKI is now preferred over acute renal failure to standardize the definition and to reflect the mechanisms and entire spectrum of the disease. The etiology is usually multifactorial. Advances in pediatric critical care and surgery depend on interventions that often involve nephrotoxic exposures. The systemic inflammatory response evoked after an extensive surgical procedure or from critical illness can also lead to organ hypoperfusion, compounding the effects of nephrotoxic exposures. AKI is an independent risk factor for mortality, prolonged intubation, and increased ICU and hospital length of stay, with even higher rates of mortality in patients receiving renal replacement therapy. Early AKI detection provides the opportunity for early intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Suggested Reading

  • Alge JL, Arthur JM. Biomarkers of AKI: a review of mechanistic relevance and potential therapeutic implications. Clin J Am Soc Nephrol. 2015;10(1):147–55.

    Article  CAS  PubMed  Google Scholar 

  • Andreoli SP. Acute kidney injury in children. Pediatr Nephrol. 2009;24(2):253–63.

    Article  PubMed  Google Scholar 

  • 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(1):184–9.

    Article  CAS  PubMed  Google Scholar 

  • Axelrod DM, Sutherland SM. Acute kidney injury in the pediatric cardiac patient. Paediatr Anaesth. 2014;24(9):899–901.

    Article  PubMed  Google Scholar 

  • Basile DP, Anderson MD, Sutton TA. Pathophysiology of acute kidney injury. Compr Physiol. 2012;2(2):1303–53.

    PubMed  PubMed Central  Google Scholar 

  • Carlotti AP, Carvalho WB. Abdominal compartment syndrome: a review. Pediatr Crit Care Med. 2009;10(1):115–20.

    Article  PubMed  Google Scholar 

  • Kellum J, Aspelin P, Barsoum R, et al. Kidney disease: improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guidelines for acute kidney injury. Kidney Int Suppl. 2012;2(1):1–138.

    Article  Google Scholar 

  • Lewington A, Kanagasundaram S. Renal association clinical practice guidelines on acute kidney injury. Nephron Clin Pract. 2011;118 Suppl 1:c349–90.

    Article  PubMed  Google Scholar 

  • Lobo DN, Macafee DA, Allison SP. How perioperative fluid balance influences postoperative outcomes. Best Pract Res Clin Anaesthesiol. 2006;20(3):439–55.

    Article  PubMed  Google Scholar 

  • Low G, Alexander GJ, Lomas DJ. Hepatorenal syndrome: aetiology, diagnosis, and treatment. Gastroenterol Res Pract. 2015;2015: 207012.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mannix R, Tan ML, Wright R, Baskin M. Acute pediatric rhabdomyolysis: causes and rates of renal failure. Pediatrics. 2006;118(5): 2119–25.

    Article  PubMed  Google Scholar 

  • Randall D, Brima N, Walker D, et al. Acute kidney injury among HIV-infected patients admitted to the intensive care unit. Int J STD AIDS. 2015;26(13):915–21.

    Article  CAS  PubMed  Google Scholar 

  • Sutherland SM, Ji J, Sheikhi FH, et al. AKI in hospitalized children: epidemiology and clinical associations in a national cohort. Clin J Am Soc Nephrol. 2013;8(10):1661–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Uniacke MD, Venkat Raman G, Hewitt J. Sodium bicarbonate use in acute kidney injury. Am J Kidney Dis. 2013;61(3):523.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aadil K. Kakajiwala MBBS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Kakajiwala, A.K., Ferguson, M.A., Fitzgerald, J.C. (2017). Acute Kidney Injury. In: Mattei, P., Nichol, P., Rollins, II, M., Muratore, C. (eds) Fundamentals of Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27443-0_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27443-0_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27441-6

  • Online ISBN: 978-3-319-27443-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics