Acute Kidney Injury
This topic was widely discussed by a Boholano Pediatric Nephrologist based in Cebu City, Dr Elmer Kent A. Lopez, last week during the Philippine Pediatric Society Central Visayas chapter first virtual postgraduate course.
Acute kidney injury is the rapid loss of glomerular filtration rate (GFR) resulting in a failure to excrete end products of nitrogen metabolism and to maintain fluid volume, electrolyte and acid- base homeostasis. In this condition, there would be an increase in serum creatinine, with decrease in urine output and thus the possibility of the need for dialysis.
The following exposures are the risk factors of acute kidney failure:
– Sepsis
– critical illness
– circulatory shock
– burns
– trauma
– cardiac surgery
– major noncardiac surgery
– nephrotoxic drugs
– radio contrast agents
– poisonous plants and animals
Dr. Elmer Kent Lopez mentioned that the common causes of Acute kidney Injury in children are the following:
– acute diarrheal disease
– excessive vomiting
– diabetes keto acidosis
– severe hemorrhage
– burns
– toxic epidermal necrolysis
– and staphylococcal scalded skin syndrome. Furthermore, he said that sepsis, congestive cardiac failure, severe allergy and some drugs could also result to AKI.
Other causes in children may include:
– glomerulonephritis
– acute tubular necrosis
– hemoglobinuria
– heavy metals
– neurogenic bladder
– urolithiasis
– and problems at the urethral valves.
Generally, Acute kidney Injury in children increases mortality from 10% to 57.1 % in patients with multiorgan failure, marrow or solid organ transplantation , ACute respiratory distress syndrome (ARDS) and those on extra corporeal membrane oxygenation (ECMO).
Clinically, acute kidney injury in children is managed by treating the underlying cause of the disease, correcting the electrolyte abnormalities, avoidance of fluid overload, providing adequate nutrition and avoiding further renal injury.
He strongly reiterated that this condition of acute kidney injury in children is common and is life-threatening and thus early recognition is a must. So, we parents and caregivers should be on the guard to any problems of our dear children and must seek professional consult on time.