AKI can cause significant morbidity and has been associated with increased mortality in children, although reported mortality rates associated with AKI vary greatly.85 Often requiring a high degree of suspicion, AKI is likely underdiagnosed in the ED setting. The lack of a unified classification system and the need for more sensitive and specific biomarkers at the time of renal injury are 2 barriers to research and improved identification of at-risk patients. The 3 major classification systems currently used for diagnosis of AKI in children are pRIFLE, AKIN, and KDIGO, which rely upon SCr and urine output parameters to define AKI.11 Future research should focus on defining a single verified classification system. However, the burden of this task is amplified by the lack of a biomarker that is capable of identifying kidney injury at its earliest stage, which would allow for earlier interventions.
To continue reading, please log in or purchase access.