Symposium: intensive careAcute kidney injury (AKI) in paediatric critical care

Incidence of acute kidney injury (AKI) is gradually increasing in children admitted to critical care units partly because of increased awareness of this entity. Though serum creatinine has been used in most definitions, its inability to accurately reflect kidney function has resulted in problems for clinical research in paediatric AKI. This has resulted in the use of more than 35 definitions of AKI in clinical studies, ranging from small changes in serum creatinine to requirement for dialysis. Therefore, comparisons among studies are difficult, resulting in a wide range of quoted epidemiology, morbidity, and mortality rates in the AKI paediatric literature. Acute kidney injury may be precipitated by critical illness, pre-existing medical conditions, and treatments received both before and during ICU admission. In this review we have attempted to outline the current definitions used for AKI, presence of AKI in various critical care conditions (bone marrow transplant, liver, sepsis, cardiac, primary renal conditions leading to glomerulonephritis) and outline the basic management.