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Epidemiology of acute kidney injury in children worldwide, including developing countries

Norbert Lameire (UGent) , Wim Van Biesen (UGent) and Raymond Vanholder (UGent)
(2017) PEDIATRIC NEPHROLOGY. 32(8). p.1301-1314
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Abstract
In this review we summarize the world-wide epidemiology of acute kidney injury (AKI) in children with special emphasis on low-income countries, notably those of the sub-Saharan continent. We discuss definitions and classification systems used in pediatric AKI literature. At present, despite some shortcomings, traditional Pediatric Risk Injury Failure Loss and End Stage Kidney Disease (pRIFLE) and Kidney Disease Improving Global Outcomes (KDIGO) systems are the most clinically useful. Alternative definitions, such as monitoring serum cystatin or novel urinary biomarkers, including cell cycle inhibitors, require more long-term studies in heterogenous pediatric AKI populations before they can be recommended in routine clinical practice. A potentially interesting future application of some novel biomarkers could be incorporation into the "renal angina index", a concept recently introduced in pediatric nephrology. The most reliable epidemiological data on AKI in children come from high-outcome countries and are frequently focused on critically ill pediatric intensive care unit populations. In these patients AKI is often secondary to other systemic illnesses or their treatment. Based on a recent literature search performed within the framework of the "AKI 0by25" project of the International Society of Nephrology, we discuss the scarce and often inaccurate data on AKI epidemiology in low-income countries, notably those on the African continent. The last section reflects on some of the many barriers to improvement of overall health care in low-income populations. Although preventive strategies for AKI in low-income countries should essentially be the same as those in high-income countries, we believe any intervention for earlier detection and better treatment of AKI must address all health determinants, including educational, cultural, socio-economic and environmental factors, specific for these deprived areas.
Keywords
Pediatric AKI, Worldwide epidemiology, Definitions of AKI, Low income countries, ACUTE-RENAL-FAILURE, CRITICALLY-ILL CHILDREN, INTENSIVE-CARE-UNIT, PEDIATRIC CARDIAC-SURGERY, LENGTH-OF-STAY, GLOMERULAR-FILTRATION RATE, CYSTATIN-C, SERUM CREATININE, HOSPITALIZED CHILDREN, CONSENSUS CONFERENCE

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Citation

Please use this url to cite or link to this publication:

Chicago
Lameire, Norbert, Wim Van Biesen, and Raymond Vanholder. 2017. “Epidemiology of Acute Kidney Injury in Children Worldwide, Including Developing Countries.” Pediatric Nephrology 32 (8): 1301–1314.
APA
Lameire, N., Van Biesen, W., & Vanholder, R. (2017). Epidemiology of acute kidney injury in children worldwide, including developing countries. PEDIATRIC NEPHROLOGY, 32(8), 1301–1314.
Vancouver
1.
Lameire N, Van Biesen W, Vanholder R. Epidemiology of acute kidney injury in children worldwide, including developing countries. PEDIATRIC NEPHROLOGY. 2017;32(8):1301–14.
MLA
Lameire, Norbert, Wim Van Biesen, and Raymond Vanholder. “Epidemiology of Acute Kidney Injury in Children Worldwide, Including Developing Countries.” PEDIATRIC NEPHROLOGY 32.8 (2017): 1301–1314. Print.
@article{8086135,
  abstract     = {In this review we summarize the world-wide epidemiology of acute kidney injury (AKI) in children with special emphasis on low-income countries, notably those of the sub-Saharan continent. We discuss definitions and classification systems used in pediatric AKI literature. At present, despite some shortcomings, traditional Pediatric Risk Injury Failure Loss and End Stage Kidney Disease (pRIFLE) and Kidney Disease Improving Global Outcomes (KDIGO) systems are the most clinically useful. Alternative definitions, such as monitoring serum cystatin or novel urinary biomarkers, including cell cycle inhibitors, require more long-term studies in heterogenous pediatric AKI populations before they can be recommended in routine clinical practice. A potentially interesting future application of some novel biomarkers could be incorporation into the {\textacutedbl}renal angina index{\textacutedbl}, a concept recently introduced in pediatric nephrology. The most reliable epidemiological data on AKI in children come from high-outcome countries and are frequently focused on critically ill pediatric intensive care unit populations. In these patients AKI is often secondary to other systemic illnesses or their treatment. Based on a recent literature search performed within the framework of the {\textacutedbl}AKI 0by25{\textacutedbl} project of the International Society of Nephrology, we discuss the scarce and often inaccurate data on AKI epidemiology in low-income countries, notably those on the African continent. The last section reflects on some of the many barriers to improvement of overall health care in low-income populations. Although preventive strategies for AKI in low-income countries should essentially be the same as those in high-income countries, we believe any intervention for earlier detection and better treatment of AKI must address all health determinants, including educational, cultural, socio-economic and environmental factors, specific for these deprived areas.},
  author       = {Lameire, Norbert and Van Biesen, Wim and Vanholder, Raymond},
  issn         = {0931-041X},
  journal      = {PEDIATRIC NEPHROLOGY},
  keyword      = {Pediatric AKI,Worldwide epidemiology,Definitions of AKI,Low income countries,ACUTE-RENAL-FAILURE,CRITICALLY-ILL CHILDREN,INTENSIVE-CARE-UNIT,PEDIATRIC CARDIAC-SURGERY,LENGTH-OF-STAY,GLOMERULAR-FILTRATION RATE,CYSTATIN-C,SERUM CREATININE,HOSPITALIZED CHILDREN,CONSENSUS CONFERENCE},
  language     = {eng},
  number       = {8},
  pages        = {1301--1314},
  title        = {Epidemiology of acute kidney injury in children worldwide, including developing countries},
  url          = {http://dx.doi.org/10.1007/s00467-016-3433-2},
  volume       = {32},
  year         = {2017},
}

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