Mohrer Daniel, Langhan Melissa
Pediatric Resident, Yale-New Haven Children's Hospital, New Haven, CT.
Associate Professor of Pediatrics and Emergency Medicine; Fellowship Director, Director of Education, Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT.
Pediatr Emerg Med Pract. 2017 May;14(5):1-24. Epub 2017 May 2.
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children. The management of pediatric acute kidney injury focuses on identifying patients at high risk, monitoring intravascular volume status, avoiding nephrotoxic medication exposure, and involving a pediatric nephrologist once acute kidney injury is diagnosed.
小儿急性肾损伤是一种在急诊科就诊的儿童中未得到充分诊断的疾病，它与显著的发病率和死亡率相关，包括慢性肾脏病风险增加。目前已知小儿患者中最常见的病因是低血容量、脓毒症、休克和心功能不全。本期探讨了急性肾损伤诊断和分期的3种分类系统，并回顾了导致儿童肾损伤的病因。小儿急性肾损伤的管理重点在于识别高危患者、监测血管内容量状态、避免接触肾毒性药物，以及一旦诊断为急性肾损伤就让小儿肾脏病专科医生参与治疗。
