Acute kidney injury (AKI) is a condition that affects a very high percentage of people worldwide, and late detection of the condition increases mortality. Utilizing current AKI biomarkers in LMICs is difficult. New data suggests that renin may function as a kidney damage biomarker that can overcome the constraints of creatinine-based diagnostics.
Methods: In Uganda, two study populations were evaluated. 600 children with severe malaria (SM) were included in Cohort #1, a prospective cohort research conducted over two sites. A prospective cohort study called Cohort #2 enrolled 185 sickle cell disease (SCD) patients who were hospitalized for a vasoocclusive crisis.When the children in both cohorts were admitted to the hospital, the quantities of plasma or serum renin were determined using Luminex® (Luminex Corporation, Austin, Texas, United States) or an enzyme-linked immunosorbent assay (ELISA), respectively. Using receiver operating characteristic curves, we evaluated the ability of renin to distinguish between children with or without AKI as well as between children who survived and those who died.
Results: Renin concentrations were significantly correlated with mortality and AKI in both groups. With an area under the curve (AUC) of 0.70 (95%CI, 0.65-0.74) in children with SM and 0.72 (95%CI, 0.6co3-0.81) in children with SCD, Renin was able to distinguish between children with and without AKI.Renin and urine neutrophil gelatinase-associated lipocalin (NGAL), the primary biomarker of AKI used in Cohort #2, performed similarly in terms of differentiating AKI and predicting mortality.
Conclusions: Renin was highly related with AKI and mortality in two different populations of children at risk of AKI, with important differences in the etiology of kidney injury. Renin also showed a moderate to good diagnostic performance to predict mortality.
What are the causes of AKI in children?
Children's Acute Kidney Injury (AKI) can be brought on by a number of different things. Some of the frequent causes of AKI in children, according to UpToDate, include:
Hypovolemia: Reduced blood volume as a result of fluid loss, dehydration, or reduced fluid intake.
Low blood pressure or a reduced cardiac output both indicate hemodynamic instability.
Nephrotoxic medicines: Some drugs, including aminoglycosides, nonsteroidal anti-inflammatory drugs (NSAIDs), and contrast compounds used in imaging tests, can harm the kidneys.
AKI can be brought on by infections, including urinary tract infections, sepsis, and others.
Blockage of the urinary tract brought on by kidney stones, tumors, or other conditions is known as obstruction.
AKI in children can also be brought on by hereditary conditions, autoimmune illnesses, and exposure to pollutants in the environment.
What are the symptoms of AKI in children?
Depending on the underlying cause, children's acute kidney injury (AKI) symptoms can change. Some typical signs include:
being ill or feeling ill
Diarrhea
Dehydration
reduced urine production
Confusion
It's crucial to remember that these symptoms might also be a sign of other illnesses. It is recommended to visit a healthcare provider for an accurate diagnosis and the best course of action if you believe your child may have AKI.
How is AKI treated in children?
The underlying cause and the severity of the ailment determine the course of treatment for acute kidney injury (AKI) in children. Typical methods of treatment include:
Increasing fluid intake, treating infections with antibiotics, and utilizing intravenous (IV) fluids and nutrition to rebalance fluids and minerals in the blood are all steps in stabilizing your child's health.
Drug adjustments: Reducing dosages of drugs that might be causing kidney issues.
Control of blood pressure: Medicines can be prescribed to maintain blood pressure.
It's crucial to remember that the treatment strategy will be unique to your child's requirements and may incorporate a number of these methods. For individualized advice and direction if your child has been diagnosed with AKI, it is advisable to speak with a healthcare expert.
What are the long-term effects of AKI on children's health?
Children who suffer from acute kidney injury (AKI) may experience both immediate and long-term effects. AKI can have long-term negative implications on a child's health, including a higher chance of developing hypertension and chronic kidney disease (CKD). The risk of cardiovascular disease is raised by certain conditions.
But it's critical to remember that there are currently few evidence-based recommendations and inadequate long-term follow-up for kids who develop AKI. To better comprehend the long-term impacts and results of AKI in children, more study is required.
