Acute kidney injury

The definition and classification of acute kidney injury (AKI) in children has become clearer over the last decade. The paediatric RIFLE criteria stratify AKI in children into five groups (R = risk, I = injury, F = failure, L = loss of kidney function, E = end stage renal disease) enabling earlier recognition and intervention. This article reviews the definition, classification, causes and management of AKI as relevant to the general paediatrician.Common causes of AKI in neonates and children are reviewed including E. Coli associated haemolytic uraemic syndrome, hypoxic ischaemic insults and medication related kidney injury. Initial management of acute kidney injury and its complications is outlined in the context of the role of the general paediatrician and factors which should prompt discussion with a tertiary paediatric nephrologist. The outcome and complications of kidney injury are discussed and future directions in the field considered.