title: Evaluation and management of critically ill children with acute kidney injury.
abstract: OBJECTIVE
  This review will highlight recent studies on the diagnosis of acute kidney injury (AKI), review the differential diagnosis, highlight the importance of cumulative fluid overload and provide key management strategies for the pediatric patient with AKI.
  
  
  RESULTS
  Over the last decade, serum creatinine-based categorical definitions of AKI have been accepted, which allow detection earlier in the disease process. Evidence-based modifications of these definitions have occurred. Fluid overload portends poor outcomes in critically ill patients. Significant improvements in our understanding of the pathophysiology of glomerular/vascular causes of AKI have occurred.
  
  
  CONCLUSIONS
  Categorical definitions of AKI have shown that higher AKI portends poor outcomes even with adjustment for severity of illness and other confounders. Cumulative fluid overload independently predicts poor outcomes. Strategies to prevent and/or treat fluid overload are likely to improve outcomes.
authors.affiliation: University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. daskenazi@peds.uab.edu
authors.forename: David
authors.initials: D
authors.lastname: Askenazi
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D002648:Child; D003404:Creatinine / Q000097:blood*; D016638:Critical Illness; D003937:Diagnosis, Differential; D005440:Fluid Therapy / Q000009:adverse effects; D006801:Humans; D017582:Renal Replacement Therapy
chemical_list: D015415:Biomarkers; D003404:Creatinine