Treatment depends on how severe the AKI is and whether it causes any complications.
Many children with AKI will not need special treatment and their kidneys will heal themselves over a few days or weeks – especially if the AKI is not severe and there are no other complications, such as infection.
Some children, however, will need more intensive treatment. Your child may need to stay in a hospital for a few days or longer while their kidneys get better. Your child’s healthcare team will make sure your child has the right amount of water and salts in the body while their kidneys get better. They may also need to stop any medicines that your child is taking that could be harming their kidneys.
Some children are referred to a paediatric renal unit, a special unit for children with kidney problems, which may be in a different hospital to your local one. Your child will be referred to a paediatric renal unit if they need additional investigations or more intensive treatment.
A few children are treated in a paediatric intensive care unit (PICU), if they are seriously unwell.
Your child can go home once their kidneys are recovering and their healthcare team are happy with their progress. Your child will have follow-up appointments as an outpatient, to monitor how well their kidneys are recovering after the AKI.
Changes to eating and drinking
Your child may need to make temporary changes to what they eat and drink, such as having less salt and fluid such as water, squash and soft drinks. The food we eat gives us nutrients, which we need to grow and stay healthy. Some children with AKI do not get enough nutrients, and need to take nutritional supplements, as tablets, capsules or liquid. Your child’s healthcare team or a paediatric dietitian will talk to you about any changes that may be needed.
Some children may need a feeding device to make sure they get the nutrients they need.
Suppressing the immune system
Some children get AKI because of problems with their immune system, which normally protects the body from disease or infection. Steroids and other immunosupressants are medicines that suppress the immune system – they stop it from fully working, so that it stops attacking the body. These medicines are usually taken by mouth, as tablets, capsules or liquid medicine but can be given as infusions if the AKI is severe.
It is important that you follow your doctor’s instructions about when and how much medicine to give. Continue to give the medicine to your child as your doctor has told you, even if they are getting better.
Treating blockages
Many children with post-renal AKI have an obstruction, or blockage, in their urinary system.
There are different ways that these can be treated. Your doctor will explain what will happen and how to prepare for it.
Urinary catheterisation
A procedure called urinary catheterisation drains urine from the bladder. This is done using a catheter, a thin, flexible tube. There are two types of urinary catheters:
- urethral catheter – placed through the urethra
- suprapubic catheter – inserted through the tummy skin, using a needle
The kidneys usually recover a few weeks after urinary catheterisation.
Surgery
If your child has a more complicated blockage, they may need to have an operation, or surgery.
Your doctor will explain what will happen and how to prepare for it. The kidneys usually improve a few weeks after surgery. Occasionally, there is an infection, which will be treated, but may delay your child’s recovery. Your doctor will give you more information.
Treating complications
Controlling blood pressure
Children with AKI may have high blood pressure, or hypertension. Their blood pressure will need to be controlled so it is in a healthy range. If your child has hypertension, they may need to change what they eat and drink. Some children need to take medicines.
Reducing swelling in the body
Very occasionally, children with AKI need to take diuretics. These medicines help reduce oedema (swelling in the body) by removing extra water and salt from the body and by increasing the amount of urine that is passed. Your doctor will examine your child for oedema and measure their weight while they are taking diuretics, to check how well the medicine is working.
Managing reduced kidney function
Children with AKI have reduced kidney function, which means that their kidneys do not work as well as they should. In most cases, kidney function returns to normal and there are no long-term problems. However, in rare cases, children whose kidney function is severely affected, will need more intensive treatment which can include dialysis. Dialysis uses special equipment to temporarily do the job of the kidneys – remove waste products and extra water from the body.
It is important to follow any treatment plan outlined by your doctor.
Questions to ask your child's medical team
- What treatment does my child need?
- How will the treatment help my child?
- How long will my child be in hospital?
- How can I help my child prepare for procedures and treatments?
- If the first treatment does not work in my child, what happens next?
- How will I know if we need to go back to the hospital or see the doctor?
- Will the AKI come back? How will I know?