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<< Acute Kidney Injury in Pediatric Patients: Diagnosis and Management in the Emergency Department (Pharmacology CME)

Introduction

Acute kidney injury (AKI) refers to a sudden loss of kidney function resulting in a decline in the glomerular filtration rate (GFR) and a reduced capacity to excrete nitrogenous waste and regulate extracellular volume and electrolytes. AKI is an increasing problem in children as the medical care being administered becomes increasingly complex. An initial report of hospitalization data revealed an AKI diagnosis in 3.9 per 1000 hospitalized patients; however, the true incidence may be higher, as most diagnostic criteria rely on knowledge of a patient's baseline creatinine level.1-4 While the incidence of AKI is higher among children who are hospitalized or in the intensive care unit (ICU), the incidence among children presenting to the emergency department (ED) is unclear.5 In one surveillance study, only 18.5% of pediatric patients who had AKI during hospitalization were diagnosed in the ED, with the majority developing AKI after admission.6

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