The Neglected Price of Pediatric Acute Kidney Injury: Non-renal Implications

Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortalit...

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Vydané v:Frontiers in pediatrics Ročník 10; s. 893993
Hlavní autori: Pande, Chetna K., Smith, Mallory B., Soranno, Danielle E., Gist, Katja M., Fuhrman, Dana Y., Dolan, Kristin, Conroy, Andrea L., Akcan-Arikan, Ayse
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland Frontiers Media S.A 30.06.2022
Predmet:
acute kidney injury
acute lung injury
cardiac dysfunction
functional status
growth
pediatric critical care medicine
Pediatrics
pediatric critical care medicine
neurologic injury
functional status
acute kidney injury
cardiac dysfunction
growth
acute lung injury
immunoparalysis
ISSN:2296-2360, 2296-2360
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Abstract Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.
AbstractList Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.
Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.
Author Smith, Mallory B.
Soranno, Danielle E.
Dolan, Kristin
Conroy, Andrea L.
Pande, Chetna K.
Gist, Katja M.
Fuhrman, Dana Y.
Akcan-Arikan, Ayse
AuthorAffiliation 7 Division of Nephrology, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh , Pittsburgh, PA , United States
9 Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine , Indianapolis, IN , United States
1 Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital , Houston, TX , United States
2 Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington , Seattle, WA , United States
3 Harborview Injury Prevention and Research Center, University of Washington , Seattle, WA , United States
6 Division of Critical Care Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh , Pittsburgh, PA , United States
8 Division of Critical Care Medicine, Department of Pediatrics, University of Missouri Kansas City, Children's Mercy Hospital , Kansas City, MO , United States
10 Division of Nephrology, Depar
AuthorAffiliation_xml – name: 1 Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital , Houston, TX , United States
– name: 7 Division of Nephrology, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh , Pittsburgh, PA , United States
– name: 6 Division of Critical Care Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh , Pittsburgh, PA , United States
– name: 10 Division of Nephrology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital , Houston, TX , United States
– name: 5 Division of Cardiology, Department of Pediatrics, Cioncinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine , Cincinnati, OH , United States
– name: 3 Harborview Injury Prevention and Research Center, University of Washington , Seattle, WA , United States
– name: 2 Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington , Seattle, WA , United States
– name: 9 Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine , Indianapolis, IN , United States
– name: 8 Division of Critical Care Medicine, Department of Pediatrics, University of Missouri Kansas City, Children's Mercy Hospital , Kansas City, MO , United States
– name: 4 Section of Nephrology, Departments of Pediatrics, Bioengineering and Medicine, University of Colorado , Aurora, CO , United States
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  fullname: Akcan-Arikan, Ayse
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Copyright © 2022 Pande, Smith, Soranno, Gist, Fuhrman, Dolan, Conroy and Akcan-Arikan. 2022 Pande, Smith, Soranno, Gist, Fuhrman, Dolan, Conroy and Akcan-Arikan
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Keywords pediatric critical care medicine
neurologic injury
functional status
acute kidney injury
cardiac dysfunction
growth
acute lung injury
immunoparalysis
Language English
License Copyright © 2022 Pande, Smith, Soranno, Gist, Fuhrman, Dolan, Conroy and Akcan-Arikan.
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Edited by: Lakshmi Raman, University of Texas Southwestern Medical Center, United States
Reviewed by: Keia Sanderson, University of North Carolina Hospitals, United States; Warwick Wolf Butt, Royal Children's Hospital, Australia
These authors have contributed equally to this work and share first authorship
This article was submitted to Pediatric Critical Care, a section of the journal Frontiers in Pediatrics
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Snippet Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the...
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SubjectTerms acute kidney injury
acute lung injury
cardiac dysfunction
functional status
growth
pediatric critical care medicine
Pediatrics
Title The Neglected Price of Pediatric Acute Kidney Injury: Non-renal Implications
URI https://www.ncbi.nlm.nih.gov/pubmed/35844733
https://www.proquest.com/docview/2691459491
https://pubmed.ncbi.nlm.nih.gov/PMC9279899
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