Acute Kidney Injury in In Paediatrics

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Paediatric Incidence of AKI • Recent study by Schneider, et al (n=3396) • 10% incidence of AKI in patients admitted to PICU • AKI increased mortality and LOS four-fold • Schneider J, et al: Crit Care Med 2010; 38:933–939 • AKI increases mortality from 10% to 57.1% in patients • with multi-organ failure, • marrow or solid organ transplantation, • extracorporeal membrane oxygenation, or • acute respiratory distress syndrome Askenazi DJ, et al:. Pediatr Crit Care Med 2011; 12:e1– e6
Long Term Outcomes • At 3 to 5-yr follow-up, • 40% to 50% of paediatric patients who had AKI show signs of chronic renal insufficiency, • indicating that sub-lethal injury permanently alters the renal bed. Askenazi DJ, et al: Kidney Int 2006; 69:184–189
Page 1 and 2: Acute Kidney Injury In Paediatrics
Page 3: What is AKI? • A sudden deteriora
Page 7 and 8: RIFLE vs AKIN
Page 9 and 10: pRIFLE CLASS Change in eCCl Urine O
Page 11 and 12: Biomarkers • The pRIFLE, RIFLE an
Page 13 and 14: Biomarkers • The quest to find ea
Page 15 and 16: NGAL • Urine NGAL > 50ug/ml predi
Page 17 and 18: IL-18 • Induced in the proximal r
Page 19 and 20: Management • Prevention of AKI is
Page 21 and 22: Ways to Prevent Contrast-Induced Ne
Page 23 and 24: Ways to Prevent Contrast-Induced
Page 25 and 26: Common Nephrotoxins in ICU EXOGENOU
Page 27 and 28: Management General principles of
Page 29 and 30: Maintain Renal Perfusion Vasopresso
Page 31 and 32: Maintain Renal Perfusion • Renal
Page 33 and 34: Maintain Renal Perfusion Choice of
Page 35 and 36: Cumulative Fluid Overload • The p
Page 37 and 38: Nutritional Support • Nutrition i
Page 39 and 40: Renal Replacement Therapy • Curre
Page 41 and 42: Timing of RRT • In paediatrics, t
Page 43 and 44: Differences between adult and • P
Page 45 and 46: Differences between adult and • P
Page 47 and 48: With CRRT • We must continually w
Page 49 and 50: Conclusions • Management of AKI i
Page 51 and 52: Conclusion • However, paediatric

Acute Kidney Injury in In Paediatrics

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