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TOPLINE:

Children who survived acute kidney injury (AKI) showed increased long-term risks for chronic kidney disease (CKD) and death, according to a meta-analysis.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis to determine late adverse outcomes in children who survived AKI.
• They included studies involving children who survived AKI and had a follow-up duration of at least 3 months.
• Outcomes of interest were the pooled incidence and odds of CKD, mortality, hypertension, and proteinuria after AKI.
• Researchers evaluated the quality of studies and risk of bias using relevant tools.

TAKEAWAY:

• The review included 39 studies with 16,151 children, and the follow-up duration ranged from 3 months to 18 years.
• Post-AKI pooled cumulative incidences were 17% for CKD (28 studies), 20% for proteinuria (11 studies), 16% for hypertension (15 studies), and 6% for mortality (5 studies).
• Across 15 comparator studies, children with AKI had higher odds of developing CKD than hospitalized children without AKI (odds ratio [OR], 1.74; 95% CI, 1.02-2.95; I² = 84.9%). The odds were higher in children with stage 2-3 AKI than in those with stage 1 disease.
• Across four comparator studies, AKI was associated with increased odds of mortality (OR, 1.92; 95% CI, 1.35-2.75; I² = 0%), although the evidence was graded as low certainty. No significant associations were noted between AKI and proteinuria or hypertension.

IN PRACTICE:

“Integrating AKI follow-up into existing pediatric chronic disease management frameworks may facilitate the earlier identification of CKD and timely intervention. Additionally, empowering caregivers and patients with preventive strategies, such as optimizing blood pressure control, avoiding nephrotoxic exposure, and promoting healthy lifestyle habits, may mitigate long-term complications,” the researchers wrote.

SOURCE:

The study was led by Jitendra Meena, MD, DM, of All India Institute of Medical Sciences in New Delhi, India. It was published online on May 4 in JAMA Pediatrics.

LIMITATIONS:

Quality of studies varied and several key outcomes were reported in only a small number of studies.

DISCLOSURES:

The authors did not report any funding source or conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.