Title:Acute Kidney Injury in Pediatric Heart Failure
VOLUME: 12 ISSUE: 2
Author(s):Alyssa Riley, Daniel J. Gebhard and Ayse Akcan-Arikan
Affiliation:Department of Pediatrics, Section of Pediatric Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA.
Keywords:Acute kidney injury, cardiorenal syndrome, chronic kidney disease, congenital heart surgery, pediatric heart failure
Abstract:Acute kidney injury (AKI) is very common in pediatric medical and surgical cardiac patients.
Not only is it an independent risk factor for increased morbidity and mortality in the short run,
but repeated episodes of AKI lead to chronic kidney disease (CKD) especially in the most vulnerable
hosts with multiple risk factors, such as heart transplant recipients. The cardiorenal syndrome, a term
coined to emphasize the bidirectional nature of simultaneous or sequential cardiac-renal dysfunction
both in acute and chronic settings, has been recently described in adults but scarcely reported in children. Despite the
common occurrence and clinical and financial impact, AKI in pediatric heart failure outside of cardiac surgery populations
remains poorly studied and there are no large-scale pediatric specific preventive or therapeutic studies to date. This
article will review pediatric aspects of the cardiorenal syndrome in terms of pathophysiology, clinical impact and treatment
options.
