Progress in the Diagnosis and Management of Acute Kidney Injury in Children

ABSTRACT Pediatric acute kidney injury (PAKI) is a critical renal syndrome with multiple causes and multiple pathogenic mechanisms, and might have a poor prognosis if misdiagnosed or poorly managed. So early diagnosis is imperative to avoid delays in treatment. In recent years, some biomarkers have been developed, to predict the early occurrence of AKI, such as Neutrophil gelatinase associated lipocalin (NGAL), Kidney injury molecule-1 (KIM-1), Liver-type fatty acid binding protein (L-FABP), and Interleukin-18 (IL-18). Currently, PAKI lacks effective drug therapy, and renal replacement therapy (RRT) is the main treatment for AKI. Choosing the type of renal replacement therapy（RRT), must consider the patient's primary disease, clinical status, and the advantages and disadvantages. This article reviews the different most recent diagnostic markers of PAKI, and therapeutic interventions used. RESUME La lesion renale aigue en pediatrie est un syndrome renal grave avec de multiples causes et de multiples mecanismes pathogeniques qui pourraient avoir un mauvais pronostic si le diagnostic n’est pas pose ou mal traite. Un diagnostic precoce est donc imperatif pour eviter les retards de traitement. Au cours des dernieres annees, certains biomarqueurs ont ete developpes pour predire la survenue precoce de la lesion renale aigue comme Neutrophil Gelatinase associated lipocalin (NGAL), Kidney injury molecule 1(KIM-1), Liver type fatty acid binding protein (L-FABP) et l’interleukin 18(IL-18). A l’heure actuelle, les lesions renales aigues pediatriques n’ont pas de traitement medicamenteux efficace et la therapie de transplantation renale est le principal traitement des lesions renales aigues. Le choix du type de therapie de remplacement renal doit tenir compte de la maladie primaire du patient, de son etat clinique, des avantages et inconvenients. Cet article passe en revue les differents marqueurs diagnostiques les plus recents de MRAP et les interventions therapeutiques utilisees.