Acute kidney injury (AKI) is one of the most common and potentially life-threatening conditions encountered in pediatric medicine. In this episode, we review how to recognize AKI using the KDIGO criteria, estimate baseline kidney function when no prior creatinine is available, and develop a practical framework for identifying the underlying cause.

Topics include prerenal, intrinsic, and postrenal AKI; posterior urethral valves; acute tubular necrosis; post-infectious glomerulonephritis; hemolytic uremic syndrome; acute interstitial nephritis; neonatal AKI; and the NINJA quality improvement initiative for reducing nephrotoxic kidney injury.

Coming up next: We'll shift from diagnosing AKI to managing it, including fluid resuscitation, fluid overload, indications for kidney replacement therapy, and practical bedside management strategies.

Selected References:

• KDIGO Clinical Practice Guideline for Acute Kidney Injury (2012).

• Ostermann M, et al. Acute Kidney Injury. The Lancet. 2025.

• Goldstein SL, et al. The NINJA Quality Improvement Initiative. Kidney International. 2020.

• Jetton JG, et al. The AWAKEN Study. The Lancet Child & Adolescent Health. 2017.

• Meena J, et al. Late Outcomes Following Acute Kidney Injury in Children. JAMA Pediatrics. 2026.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

Chronic kidney disease in children is fundamentally different from CKD in adults. In this episode, we review how pediatric CKD is defined and staged, why congenital anomalies of the kidney and urinary tract (CAKUT) remain the leading cause of childhood CKD, and how kidney function should be estimated across different pediatric age groups.

We also discuss common causes of pediatric CKD, the importance of nephron endowment, the impact of prematurity on lifelong kidney health, and the strengths and limitations of commonly used GFR equations, including the CKiD U25 and Bedside Schwartz equations.

Selected References:

• KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.

• Pierce CB, et al. CKiD U25 Equations for Estimating GFR in Children and Young Adults. American Journal of Kidney Diseases. 2021.

• ESCAPE Trial Group. Strict Blood Pressure Control and Progression of Chronic Kidney Disease in Children. New England Journal of Medicine. 2009.

• Warady BA, Chadha V. Chronic Kidney Disease in Children. Pediatric Clinics of North America.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

Managing pediatric chronic kidney disease extends far beyond monitoring kidney function. In this episode, we discuss evidence-based strategies to slow CKD progression, including blood pressure control, RAAS inhibition, and the treatment of common complications such as metabolic acidosis, CKD-mineral bone disorder, growth failure, and anemia.

We also review the role of ambulatory blood pressure monitoring, practical considerations when prescribing ACE inhibitors and ARBs, and why optimizing nutrition and metabolic health is essential for supporting normal growth and development in children with CKD.

Selected References:

• KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.

• ESCAPE Trial Group. Strict Blood Pressure Control and Progression of Chronic Kidney Disease in Children. New England Journal of Medicine. 2009.

• Warady BA, et al. Chronic Kidney Disease in Children. Pediatric Clinics of North America.

• Chronic Kidney Disease in Children (CKiD) Study Investigators.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

Children with chronic kidney disease have unique nutritional and developmental needs that differ significantly from adults. In this episode, we discuss evidence-based nutritional management, growth failure, recombinant human growth hormone therapy, neurocognitive outcomes, and the role of school support for children living with CKD.

We also review the timing of kidney replacement therapy, the benefits of preemptive kidney transplantation, indications for dialysis, and why peritoneal dialysis is often the preferred modality for infants and young children.

Selected References:

• KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.

• KDOQI Clinical Practice Guideline for Nutrition in Children with CKD.

• Pediatric Renal Nutrition Taskforce (PRNT) Clinical Practice Recommendations.

• Chronic Kidney Disease in Children (CKiD) Study Investigators.

• Warady BA, Chadha V. Chronic Kidney Disease in Children. Pediatric Clinics of North America.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.