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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Published in:Frontiers in pediatrics Vol. 10; p. 893993
Main Authors: Pande, Chetna K., Smith, Mallory B., Soranno, Danielle E., Gist, Katja M., Fuhrman, Dana Y., Dolan, Kristin, Conroy, Andrea L., Akcan-Arikan, Ayse
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media S.A 30.06.2022
Subjects:
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
Online Access:Get full text
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Summary: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.
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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
ISSN:2296-2360
2296-2360
DOI:10.3389/fped.2022.893993