Metabolomics of Sepsis and Acute Kidney Injury in Infants and Children: Current Challenges in Prevention, Diagnosis, and Management

Sepsis and acute kidney injury (AKI) are significant contributors to morbidity and mortality in neonates, infants, and children. This comprehensive review aimed to evaluate the application of metabolomics in the challenging diagnostic process of sepsis and AKI in neonatal and pediatric populations. We highlighted the role of metabolomic profiling in enabling the accurate identification of biomarkers associated with sepsis and AKI, allowing for the timely prevention or detection of the disease. Additionally, pharmacometabolomics was presented to ascertain the contribution of metabolomics towards optimizing an individual's drug therapy via direct measurement and monitoring of drug metabolites to predict the pharmacokinetic profiles of drug compounds. This review also addressed the obstacles in translating metabolomic research into clinical practice, including the need for standardized methodologies, age-specific reference data, and large-scale validation studies as a result of the current limited literature in this area. Ultimately, the review showcased how utilizing metabolomics-driven diagnostic and treatment guidelines can promote positive clinical outcomes in infants and children affected by sepsis-associated AKI.