Acute kidney injury happens when your child's kidneys are suddenly no longer functioning properly. Healthy kidneys clean the blood by removing excess fluid, minerals and waste. The kidneys also make hormones that keep the bones strong and the blood healthy.
Acute kidney injury can occur when:
- Your child has a condition that slows blood flow to the kidneys
- Your child has a serious infection
- Your child develops a blockage in the ureters or urethra (tubes that drain urine from the kidneys)
- Your child develops inflammation in the kidneys
- Your child develops hemolytic uremic syndrome (HUS)
- Your child has a reaction to a medicine
If your child's kidneys fail, many areas of his or her body may be affected:
- Harmful waste material builds up in his or her body
- The blood pressure may rise
- The body may retain excess fluid
- The body may not make enough red blood cells
The symptoms of acute kidney injury in children depend on the underlying cause of the organ failure and can include:
- Fever
- Rash
- Bloody diarrhea
- Vomiting
- Abdominal pain
- No urine output or high urine output
- History of recent infection
- Pale skin
- Swelling of the tissues
- Inflammation of the eye
- Lethargy
- Fatigue
Diagnosis of Acute Kidney Injury
Your child’s nephrologist will use one or more of the following tests to diagnose acute kidney injury:
- Blood tests. A sample of your child’s blood is drawn and tested to determine how much blood the kidneys filter each minute. This is called the estimated glomerular filtration rate (eGFR). Other blood tests may be ran to determine the blood urea nitrogen (BUN), creatinine and electrolytes.
- Urine test. A sample of your child’s urine is tested for abnormalities that can cause acute kidney injury.
- Ultrasound. An ultrasound can help the doctor assess the kidneys’ size and structure.
- Renal biopsy. A renal biopsy (removing a sample of tissue for testing) can help your child’s doctor pinpoint the cause of the kidney problem.
Treatments
Treatments
The course of treatment that your child’s nephrologist recommends will depend on the following factors:
- Your child’s age, overall health and medical history
- The degree of kidney injury
Potential treatments for acute kidney injury include:
- Fluid management. Your child’s doctor may recommend treatments to balance the amount of fluids in your child’s blood. If there is too much fluid in the blood, the doctor may prescribe diuretics (water pills) to reduce the fluid. If there is not enough fluid in the blood, the doctor may recommend intravenous (IV) fluids.
- Medicines. Your child’s doctor may prescribe medicines to prevent the accumulation of potassium in the blood, which can occur when the kidneys are not properly filtering the blood. If your child’s blood calcium is low, the doctor may prescribe medicines to help restore a normal blood calcium level.
- Diet modifications. Your child should try to avoid foods that are high in potassium, such as bananas, oranges, tomatoes and potatoes. Also, offer foods that are lower in sodium (salt). Your child should also try to limit his or her intake of phosphorous-containing foods, such as dairy products, dried beans, nuts and peanut butter.
- Acute hemodialysis. In this treatment, a machine and filter do the work that your kidneys normally do, removing waste and other materials from the blood. Hemodialysis helps to control blood pressure and helps the body maintain the proper balance of important minerals such as potassium, sodium, calcium and bicarbonate.
- Peritoneal dialysis. Instead of using a machine outside the body to perform the kidneys’ functions, waste is filtered through the lining of the abdomen which acts as an artificial kidney. After receiving thorough training, you can help your child undergo this type of dialysis at home on your own schedule.
- Continuous renal replacement therapy (CRRT). CRRT is a form of continuous veno-venous hemofiltration that can be performed with or without dialysis. Continuous veno-venous hemofiltration with dialysis—or CVVH(D)—is performed in the intensive care unit to clean the blood with a machine. CVVH(D) helps control fluid balance and blood pressure and can remove waste products from the blood.
Key Points to Remember
Key Points to Remember
- The kidneys serve the important function of filtering waste from the blood as well as regulating other functions of the body.
- When the kidneys fail, your child needs treatment to help remove waste from the blood.
- Treatment options include medical therapy, modification of the diet, hemodialysis, peritoneal dialysis and continuous veno-venous hemofiltration with dialysis.
Support Services & Resources
Support Services & Resources
Visit the trusted websites below to learn more about acute kidney injury.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
Visit this National Institutes of Health website for in-depth information on a wide variety of topics related to kidney disease.
Learn more about the treatment methods for kidney failure in children.
Visit this website to learn more about kidney failure, including its causes and treatments.
Acute Kidney Injury Research
Acute Kidney Injury Research
The pediatric nephrologists at Riley at IU Health have performed research in the causes of acute kidney injury in children and have published several review articles and book chapters about acute kidney injury in children. Ask your child's doctor for more information about this research.
Locations
Locations
Locations
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.
Riley Pediatric Nephrology & Kidney Diseases
11725 N Illinois St
Carmel, IN 46032
Riley Pediatric Nephrology & Kidney Diseases
575 Riley Hospital Dr
Indianapolis, IN 46202