EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean E. Klig and Clifford W. Bogue: CRITICAL CARELong-term complications of acute kidney injury in childrenLebel, Asaf; Teoh, Chia W.; Zappitelli, MichaelAuthor Information Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada Correspondence to Michael Zappitelli, MD, MSc, Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8. Tel: +1 416 8137654x328903 or 201220; e-mail: firstname.lastname@example.org Current Opinion in Pediatrics: June 2020 - Volume 32 - Issue 3 - p 367-375 doi: 10.1097/MOP.0000000000000906 Buy Metrics Abstract Purpose of review The current review will describe the current evidence and mechanisms of acute kidney injury (AKI) as a risk factor for long-term kidney complications, summarize the rationale for AKI follow-up and present an approach to monitoring children with AKI. Despite emerging evidence linking AKI with risk for long-term kidney and cardiovascular outcomes, many children who develop AKI are not followed for kidney disease development after hospital discharge. Better understanding of long-term complications after AKI and practical algorithms for follow-up will hopefully increase the rate and quality of post-AKI monitoring. Recent findings Recent evidence shows that pediatric AKI is associated with long-term renal outcomes such as chronic kidney disease (CKD) and hypertension, both known to increase cardiovascular risk. The mechanism of AKI progression to CKD involves maladaptive regeneration of tubular epithelial and endothelial cells, inflammation, fibrosis and glomerulosclerosis. Many AKI survivors are not followed, and no guidelines for pediatric AKI follow-up have been published. Summary Children who had AKI are at increased risk of long-term renal complications but many of them are not monitored for these complications. Recognizing long-term outcomes post-AKI and integration of follow-up programs may have a long-lasting positive impact on patient health. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.