Oligüriler, Anüriler
Özet
Çocuklarda idrar çıkışının azalması (oligüri ve anüri), akut böbrek hasarının erken teşhisinde kreatinin seviyelerinden daha hızlı sonuç veren kritik bir göstergedir. Bu durum prerenal (dehidratasyon, hipovolemi), renal (parankim hasarı) veya postrenal (obstrüksiyon) nedenlerden kaynaklanabilir ve tanıda pRIFLE ile KDIGO gibi standart evreleme kriterleri kullanılır. Tedavi sürecinde sıvı dengesinin sağlanması, elektrolit bozukluklarının giderilmesi ve altta yatan etiyolojinin hızlıca belirlenmesi hayati önem taşır.
Reduced urine output in children (oliguria and anuria) is a critical indicator for early diagnosis of acute kidney injury, providing more immediate results than creatinine levels. This condition can stem from prerenal (dehydration, hypovolemia), renal (parenchymal damage), or postrenal (obstruction) causes, and diagnosis relies on standardized staging criteria such as pRIFLE and KDIGO. In the treatment process, maintaining fluid balance, addressing electrolyte imbalances, and rapidly identifying the underlying etiology are of vital importance.
Referanslar
Kaddourah A, Basu RK, Bagshaw SM, et al. Epidemiology of Acute Kidney Injury in Critically Ill Children and Young Adults. N Engl J Med. 2017;376(1):11-20. doi: 10.1056/NEJMoa1611391.
Kaddourah A, Basu RK, Goldstein SL, et al. Oliguria and Acute Kidney Injury in Critically Ill Children: Implications for Diagnosis and Outcomes. Pediatr Crit Care Med. 2019;20(4):332-339. doi: 10.1097/PCC.0000000000001866.
Goldstein SL. Urine Output Assessment in Acute Kidney Injury: The Cheapest and Most Impactful Biomarker. Front Pediatr. 2020;7:565. doi: 10.3389/fped.2019.00565
Goldstein SL, Zappitelli M. (2016). Evaluation and Management of Acute Kidney Injury in Chidren. In E. Avner, P. Niaudet, F. Emma, W.E. Harmon, N. Yoshikawa, S.L. Goldstein (Ed.s), Pediatric Nephrology (7th ed., pp. 2139-2167). Heidelberg: Springer
Düzova A., Bakkaloğlu A. (2020). Akut Böbrek Hasarı. E. Hasanoğlu, R. Düşünsel, A. Bideci, K. Bosuroğlu (Ed.) Temel Pediatri (2. Baskı) içinde (s.1765-1772) Ankara:Güneş Kitabevi
Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-84. doi: 10.1159/000339789.
Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int. 2007;71(10):1028-35. doi: 10.1038/sj.ki.5002231
Pınarbaşı A.S. (2018). Akut Böbrek Hasarı. F. Baştuğ, R. Düşünsel (Ed.), Çocuk Nefroloji El Kitabı içinde (s.224-234). Ankara: Çocuk Nefroloji Derneği.
Sutherland SM, Byrnes JJ, Kothari M, et al. AKI in hospitalized children: comparing the pRIFLE, AKIN, and KDIGO definitions. Clin J Am Soc Nephrol. 2015;10(4):554-61. doi: 10.2215/CJN.01900214.
Vachvanichsanong P, Dissaneewate P, Lim A, McNeil E. Childhood acute renal failure: 22-year experience in a university hospital in southern Thailand. Pediatrics. 2006;118(3):e786-91. doi: 10.1542/peds.2006-0557.
Parikh RV, Tan TC, Salyer AS, et al. Community-Based Epidemiology of Hospitalized Acute Kidney Injury. Pediatrics. 2020;146(3):e20192821. doi:10.1542/peds.2019-2821
Macedo E, Cerdá J, Hingorani S, et al. Recognition and management of acute kidney injury in children: The ISN 0by25 Global Snapshot study. PLoS One. 2018;13(5):e0196586 doi:10.1371/journal.pone.0196586
Devarajan P. (2020). Acute Kidney Injury. In R. M. Kliegman, J. W. St Geme, N. J. Blum, S. S. Shah, R. C. Tasker, K. M. Wilson (Ed.s), Nelson Textbook of Pediatrics (21st ed, pp. 2769-2774 ) Philadelphia: Elsevier
Askenazi DJ, Feig DI, Graham NM, Hui-Stickle S, Goldstein SL. 3-5 year longitudinal follow-up of pediatric patients after acute renal failure. Kidney Int. 2006;69(1):184-9. doi: 10.1038/sj.ki.5000032.
