Summary

• Paediatric AKI can be preventable; early detection and appropriate management can reduce harm
• Risk assessment for Paediatric AKI involves identifying high risk groups and high risk scenarios for AKI and using clinical judgement to determine whether serum creatinine testing is required
• AKI prevention and management involves careful assessment and monitoring, maintaining circulation and minimising kidney insults (the 3Ms)

Summary flow diagram of British Association of Paediatric Nephrologists(BAPN) AKI guidelines [4]

Pitfalls

The following groups of children with AKI are at high risk of requiring renal replacement therapy and require urgent Involvement of the Paediatrics team with nephrology input:

• Potassium >6.5mmol/l (non-haemolysed sample)
• Oligoanuria and plasma sodium <125mmol/l
• Pulmonary oedema or hypertension unresponsive to diuretics
• Plasma urea >40mmol/l unresponsive to fluid challenge.