TY - JOUR
T1 - The Neglected Price of Pediatric Acute Kidney Injury
T2 - Non-renal Implications
AU - Pande, Chetna K.
AU - Smith, Mallory B.
AU - Soranno, Danielle E.
AU - Gist, Katja M.
AU - Fuhrman, Dana Y.
AU - Dolan, Kristin
AU - Conroy, Andrea L.
AU - Akcan-Arikan, Ayse
N1 - Publisher Copyright:
Copyright © 2022 Pande, Smith, Soranno, Gist, Fuhrman, Dolan, Conroy and Akcan-Arikan.
PY - 2022/6/30
Y1 - 2022/6/30
N2 - Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.
AB - Preclinical models and emerging translational data suggest that acute kidney injury (AKI) has far reaching effects on all other major organ systems in the body. Common in critically ill children and adults, AKI is independently associated with worse short and long term morbidity, as well as mortality, in these vulnerable populations. Evidence exists in adult populations regarding the impact AKI has on life course. Recently, non-renal organ effects of AKI have been highlighted in pediatric AKI survivors. Given the unique pediatric considerations related to somatic growth and neurodevelopmental consequences, pediatric AKI has the potential to fundamentally alter life course outcomes. In this article, we highlight the challenging and complex interplay between AKI and the brain, heart, lungs, immune system, growth, functional status, and longitudinal outcomes. Specifically, we discuss the biologic basis for how AKI may contribute to neurologic injury and neurodevelopment, cardiac dysfunction, acute lung injury, immunoparalysis and increased risk of infections, diminished somatic growth, worsened functional status and health related quality of life, and finally the impact on young adult health and life course outcomes.
KW - acute kidney injury
KW - acute lung injury
KW - cardiac dysfunction
KW - functional status
KW - growth
KW - immunoparalysis
KW - neurologic injury
KW - pediatric critical care medicine
UR - http://www.scopus.com/inward/record.url?scp=85134182599&partnerID=8YFLogxK
U2 - 10.3389/fped.2022.893993
DO - 10.3389/fped.2022.893993
M3 - Review article
C2 - 35844733
AN - SCOPUS:85134182599
SN - 2296-2360
VL - 10
JO - Frontiers in Pediatrics
JF - Frontiers in Pediatrics
M1 - 893993
ER -