Acute Kidney Injury: A Not So Silent Disease

@article{Siew2014AcuteKI,
  title={Acute Kidney Injury: A Not So Silent Disease},
  author={Edward D. Siew and Susan L. Furth},
  journal={Kidney international},
  year={2014},
  volume={85},
  pages={494 - 495}
}
  • E. Siew, S. Furth
  • Published 18 October 2013
  • Medicine, Biology
  • Kidney international
Hospitalized children are experiencing acute kidney injury (AKI) with increasing frequency and are especially vulnerable to its long-term complications. Attempts to leverage novel biomarkers to improve phenotyping of this disease are limited by untargeted testing within broadly selected populations. Here, we review efforts by Basu et al. to use readily available clinical information to identify critically ill children at higher risk for developing severe AKI and who may benefit from novel… 

Biomarkers for the Early Detection and Prognosis of Acute Kidney Injury.

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TLDR
This review highlights some of the lessons learned in conducting AKI biomarker studies, including ongoing attempts to address the limitations of creatinine as a reference standard and the recent shift toward evaluating the prognostic potential of these markers.

Epidemiology of acute kidney injury in children worldwide, including developing countries

TLDR
Any intervention for earlier detection and better treatment of AKI must address all health determinants, including educational, cultural, socio-economic and environmental factors, specific for these deprived areas.

Pediatric acute kidney injury: A syndrome under paradigm shift

TLDR
The recent standardization and validation of definitions of pediatric acute kidney injury (pAKI) has ignited new dimensions of pAKI epidemiology and its risk factors, and important aspects of pakI management are highlighted.

Evidence-Based Nephrology Biomarkers for the Early Detection and Prognosis of Acute Kidney Injury

TLDR
This review highlights some of the lessons learned in conducting AKI biomarker studies, including ongoing attempts to address the limitations of creatinine as a reference standard and the recent shift toward evaluating the prognostic potential of these markers.

References

SHOWING 1-10 OF 15 REFERENCES

We can diagnose AKI "early".

Proteinuria was first identified as a strong risk factor for AKI in 2008 ([1][1]). These observations were subsequently confirmed and extended in several other clinical scenarios and patient groups

Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children.

TLDR
The renal angina concept is operationalized by deriving and validating the RAI for prediction of subsequent severe AKI and may potentially reduce capricious AKI biomarker use by identifying patients in whom further testing would be most beneficial.

Urine neutrophil gelatinase-associated lipocalin moderately predicts acute kidney injury in critically ill adults.

TLDR
Although a single measurement of uNGAL exhibited moderate predictive utility for the development and severity of AKI in a heterogeneous ICU population, its additional contribution to conventional clinical risk predictors appears limited.

Postoperative biomarkers predict acute kidney injury and poor outcomes after pediatric cardiac surgery.

TLDR
Elevated urine IL-18 and urine NGAL levels associated with longer hospital stay, longer intensive care unit stay, and duration of mechanical ventilation, but not plasma NGAL, associate with subsequent AKI and poor outcomes among children undergoing cardiac surgery.

Early intervention with erythropoietin does not affect the outcome of acute kidney injury (the EARLYARF trial).

TLDR
The study showed that a composite of these two biomarkers was insufficient for risk stratification in a patient population with a heterogeneous onset of injury, and early intervention with high-dose erythropoietin was safe but did not alter the outcome.

Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis.

TLDR
A systematic review of cohort studies evaluating long-term renal outcomes and non-renal outcomes in patients with and without AKI identifies AKI as an independent risk factor for CKD, ESRD, death, and other important non- renewable outcomes.

Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001.

TLDR
Pediatric ARF epidemiological characteristics have changed from primary renal disease to renal involvement secondary to other systemic illness, and longitudinal data from this cohort are underway to determine the long-term sequelae of pediatric ARF.

Imperfect gold standards for kidney injury biomarker evaluation.

TLDR
The results of this study suggest that small changes in serum creatinine alone should not be used to define acute kidney injury in biomarker or interventional studies.

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