What type of study is this?

This is a Meta-Analysis study (also classified as: Systematic Review).

What question did this study set out to answer?

To estimate the risks of chronic kidney disease, mortality, hypertension, and proteinuria after acute kidney injury in hospitalized children.

May 6, 2026

Late Outcomes Following Acute Kidney Injury in Children

Key Points

To estimate the risks of chronic kidney disease, mortality, hypertension, and proteinuria after acute kidney injury in hospitalized children.
Systematic review and meta-analysis of studies reporting long-term outcomes after AKI.
Data extracted independently by two reviewers, assessing risk of bias.
Pooled cumulative incidences and odds ratios computed using random-effects meta-analyses.
17% incidence of chronic kidney disease after AKI; 6% for mortality; 20% for proteinuria; 16% for hypertension.
Odds of CKD and mortality significantly higher in children post-AKI, at 1.74 and 1.92 respectively.
Greater AKI severity linked to higher risk of CKD, with ORs ranging from 1.72 to 2.84.

Abstract

Importance: Acute kidney injury (AKI) is a common complication among hospitalized children and may have lasting kidney and cardiovascular consequences. However, the long-term risks after pediatric AKI have not been comprehensively quantified. Objective: To estimate the pooled incidence and relative risk with odds ratio of chronic kidney disease (CKD), mortality, hypertension, and proteinuria following AKI in hospitalized children. Data Sources: PubMed, Embase, and Web of Science were searched from January 2007 through November 2025 without language restrictions. Study Selection: Studies were included if they reported at least 1 long-term outcome (CKD, mortality, hypertension, or proteinuria) following AKI in hospitalized children. Studies limited to children with obstructive lesions, primary vascular disorders (eg, hemolytic uremic syndrome) or solid organ transplant were excluded. Data Extraction and Synthesis: Two reviewers independently extracted data and assessed risk of bias. Random-effects meta-analyses were performed to estimate pooled cumulative incidences and odds ratios (ORs) with 95% CIs. Main Outcomes and Measures: Cumulative incidence and odds of CKD, mortality, hypertension, and proteinuria following pediatric AKI. Results: Of 17 068 screened records, 39 studies comprising 16 151 participants were included. The pooled cumulative incidences following AKI were 17% (95% CI, 12-22) for CKD, 6% (95% CI, 3-8) for mortality, 20% (95% CI, 12-29) for proteinuria, and 16% (95% CI, 11-23) for hypertension. In 23 studies with non-AKI comparators and follow-up ranging from 3 months to 18 years, AKI was associated with increased odds of CKD (OR, 1.74; 95% CI, 1.02-2.95) and mortality (OR, 1.92; 95% CI, 1.35-2.75) but not proteinuria (OR, 1.18; 95% CI, 0.62-2.25) or hypertension (OR, 1.29; 95% CI, 0.72-2.31). Greater AKI severity was associated with a higher odds of CKD (stages 2-3: OR, 2.84; 95% CI, 1.49-4.15; stage 1: OR, 1.72; 95% CI, 1.11-2.67). Conclusions and Relevance: The findings in this systematic review and meta-analysis demonstrate that, similar to adults, children experienced increased risk of late adverse outcomes following AKI, particularly CKD and mortality, supporting the need for structured post-AKI follow up.

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Cite This Study

Meena et al. (Mon,) studied this question.

synapsesocial.com/papers/69faa28f04f884e66b5332ed https://doi.org/https://doi.org/10.1001/jamapediatrics.2026.1357

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