Hessey Erin, Melhem Nabil, Alobaidi Rashid, Ulrich Emma, Morgan Catherine, Bagshaw Sean M, Sinha Manish D
Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Pediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom.
Front Pediatr. 2021 Mar 15;9:648587. doi: 10.3389/fped.2021.648587. eCollection 2021.
Acute kidney injury (AKI) in the pediatric intensive care unit (PICU) is an important risk factor for increased morbidity and mortality during hospitalization. Over the past decade, accumulated data on children and young people indicates that acute episodes of kidney dysfunction can have lasting consequences on multiple organ systems and health outcomes. To date, there are no guidelines for follow-up of surviving children that may be at risk of long-term sequelae following AKI in the PICU. This narrative review aims to describe literature from the last 5 years on the risk of medium and long-term kidney and non-kidney outcomes after AKI in the PICU. More specifically, we will focus on outcomes in children and young people following AKI in the general PICU population and children undergoing cardiac surgery. These outcomes include mortality, hypertension, proteinuria, chronic kidney disease, and healthcare utilization. We also aim to highlight current gaps in knowledge in medium and long-term outcomes in this pediatric population. We suggest a framework for future research to develop evidence-based guidelines for follow-up of children surviving an episode of critical illness and AKI.
儿科重症监护病房（PICU）中的急性肾损伤（AKI）是住院期间发病率和死亡率增加的重要危险因素。在过去十年中，有关儿童和青少年的累积数据表明，肾功能障碍的急性发作可对多个器官系统和健康结果产生持久影响。迄今为止，尚无针对在PICU中经历AKI后可能有长期后遗症风险的幸存儿童的随访指南。本叙述性综述旨在描述过去5年中关于PICU中AKI后中长期肾脏和非肾脏结局风险的文献。更具体地说，我们将关注普通PICU人群以及接受心脏手术的儿童在发生AKI后的结局。这些结局包括死亡率、高血压、蛋白尿、慢性肾脏病和医疗保健利用情况。我们还旨在突出当前该儿科人群中长期结局方面的知识空白。我们建议建立一个未来研究框架，以制定基于证据的指南，用于对经历过危重症和AKI发作的幸存儿童进行随访。
