Review Articles

Acute kidney injury in children – not just for the nephrologist

M. S. Choopa, G. van Biljon
South African Family Practice | Vol 57, No 6 : November/December| a4376 | DOI: https://doi.org/10.4102/safp.v57i6.4376 | ©
Submitted: 01 November 2015 | Published: 01 November 2015

About the author(s)

M. S. Choopa, Department of Paediatrics and Child Health, Paediatric Nephrology Unit, University of Pretoria, Pretoria, South Africa
G. van Biljon, Department of Paediatrics and Child Health, Paediatric Nephrology Unit, University of Pretoria, Pretoria, South Africa

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Abstract

Acute kidney injury (AKI) is a condition that is characterised by an abrupt reduction in kidney function, and is not limited to acute renal failure. However, it is potentially treatable. Failure to do so may result in death or progression to chronic kidney disease (CKD). AKI requires urgent management in order to ensure a better clinical outcome. Traditionally, AKI is classified according to aetiology, i.e. pre-renal, intrinsic renal and post-renal AKI. Clinical features depend on the age of the patient, the cause and related complications. Symptoms and signs may be non-specific, e.g. poor feeding and vomiting, or more specific, e.g. oedema, macroscopic haematuria and oliguria. The staging of AKI is based on the estimated glomerular filtration rate and urine output. AKI from any cause increases the risk of CKD developing, and vice versa. There are absolute indications for renal replacement therapy, e.g. anuria, whereas other patients can be managed successfully conservatively.

Keywords

acute kidney injury; AKI; children; fluid management; pRIFLE; renal replacement therapy

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