Nephrology: Edited by Michel BaumEvaluation and management of critically ill children with acute kidney injuryAskenazi, DavidAuthor Information University of Alabama at Birmingham, Birmingham, Alabama, USA Correspondence to David Askenazi, MD, MsPH, Assistant Professor of Pediatrics, University of Alabama at Birmingham, 1600 7th Avenue South, ACC 516, Birmingham, AL 35233, USA Tel: +1 205 939 9781; e-mail: [email protected] Current Opinion in Pediatrics: April 2011 - Volume 23 - Issue 2 - p 201-207 doi: 10.1097/MOP.0b013e328342ff37 Buy Metrics Abstract Purpose of review This review will highlight recent studies on the diagnosis of acute kidney injury (AKI), review the differential diagnosis, highlight the importance of cumulative fluid overload and provide key management strategies for the pediatric patient with AKI. Recent findings Over the last decade, serum creatinine-based categorical definitions of AKI have been accepted, which allow detection earlier in the disease process. Evidence-based modifications of these definitions have occurred. Fluid overload portends poor outcomes in critically ill patients. Significant improvements in our understanding of the pathophysiology of glomerular/vascular causes of AKI have occurred. Summary Categorical definitions of AKI have shown that higher AKI portends poor outcomes even with adjustment for severity of illness and other confounders. Cumulative fluid overload independently predicts poor outcomes. Strategies to prevent and/or treat fluid overload are likely to improve outcomes. © 2011 Lippincott Williams & Wilkins, Inc.