The use of diagnostic tools for pediatric AKI: applying the current evidence to the bedside

Given the known deleterious consequences of acute kidney injury (AKI), exciting recent research efforts have focused on developing strategies for the earlier recognition of AKI in the pediatric population. Recognizing the limitations of serum creatinine, investigators have focused on the study of novel biomarkers and practical bedside tools for identifying patients at risk for AKI prior to a rise in serum creatinine. In PubMed there are presently over 30 original research papers exploring the use of pediatric AKI risk prediction tools just in the last 2 years. The following review will highlight the most recent advances in the literature regarding opportunities to refine our ability to detect AKI early. Importantly, it will be discussed how prediction tools including novel urine and serum biomarkers, practical risk stratification tests, renal functional reserve and electronic medical record alerts may ultimately be applied to routine clinical practice.