Acute Kidney Injury in Children

Abstract

Acute kidney injury (AKI) is a clinical syndrome which is characterized by sudden and fast reversible loss of renal functions (with decreased glomerular filtration rate) increase in the blood ürea and concentration of creatinin and disturbances of fluid and electrolyte homeostasis.For diagnosis and classification of AKI The Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease Criteria (P-RIFLE) is used based on changes in serum creatinine and urine output. The incidence of AKI in children appears to be increasing, and the etiology of AKI over the past decade has shifted from primary renal disease to multifactorial causes, particularly in hospitalized children. Renal injury can be divided into prerenal failure, intrinsic renal disease and obstructive uropathies. Prerenal renal injury is the most common type of renal injury in childhood. The history, physical examination, and laboratory tests, including urinalysis and radiographic tests, can establish the likely cause(s) of AKI. The treatment is performed in two stage; adjustment of life-threatening disorders and determination cause of complications and regulation of treatment. The prognosis of AKI is dependent on the underlying etiology of the AKI.

Keywords

• Acute kidney injury,
• childhood,
• survive

Çocuklarda Akut Böbrek Hasarı

Abstract

Akut böbrek hasarı (ABH), böbrek fonksiyonlarının ani ve hızlı reverzibl kaybı sonucu (glomeruler filtrasyon hızında azalma ile birlikte), kan üre ve kreatinin konsantrasyonun yükseldiği, sıvı elektrolit dengesinin bozulduğu klinik bir sendromdur. Akut böbrek hasarının teşhisi ve sınıflandırılmasında serum kreatinin değişikliğini ve idrar çıkışını temel alan pediyatrik risk, hasarlanma, yetmezlik, kayıp, son dönem böbrek yetmezliği kriterleri (P-RIFLE) kullanılmaktadır.İnsidansında artış olan ABH’nın etyolojisinin son on yılda özellikle hastanede yatan çocuklar içinde primer böbrek hastalıklarından multifaktöriyel sebeplere kaydığı gözlenmiştir.Böbrek hasarı prerenal kayıp, intrinsink böbrek hastalığı ve obstrüktif üropatiler olarak ayrılabilir. Prerenal böbrek hasarı çocukluk yaşlarında en sık görülen gruptur. Hikaye, fizik muayene, idrar analizini de içeren labarotuar çalışmaları ve radyolojik çalışmalarla ABH’nın olası neden veya nedenlerisaptanabilir. Tedavi, hayatı tehdit eden bozuklukların düzeltilmesi ve komplikasyon nedenin belirlenip tedavisinin düzenlenmesi şeklinde iki aşamada gerçekleştirilir. Prognoz altta yatan etyolojiye bağlıdır.

Keywords

• Akut böbrek hasarı,
• çocukluk çağı,
• sağkalım

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