Acute Kidney Injury (AKI): Current Thoughts and Controversies in Pediatrics

AKI is a common syndrome that is independently associated with increased mortality. This review hopes to address recent advances in scoring systems as they have advanced and become paediatric specific. Causes of AKI are widespread but specifically sepsis with relevance of molecular mechanisms will be reviewed. Prevention of AKI is important and needs attention to nephrotoxic drugs specifically. Fluid management in AKI following resuscitation can be specifically challenging requiring removal if fluid overloaded and use of continuous renal replacement therapy if available. Biomarkers remain very topical but their use in practical clinical practice has been a distinct challenge. For this reason, practical attempts to identify a Renal Troponin I and resultant renal Angina score are very helpful. Neonatal AKI has its own specific challenges, and scoring systems may need to be redefined. Finally, a global initiative called ‘0 by 2025’ to eliminate preventable deaths by the ISN is a challenging global initiative with potential widespread impact. © 2015, Springer Science + Business Media New York.