text: Critical analysis of acute kidney injury in pediatric COVID 19 patients in the intensive care unit COVID 19 is responsible for the 2019 novel coronavirus disease pandemic Despite the vast research about the adult population there has been little data collected on acute kidney injury AKI epidemiology associated risk factors treatments and mortality in pediatric COVID 19 patients admitted to the ICU AKI is a severe complication of COVID 19 among children and adolescents A comprehensive literature search was conducted in PubMed MEDLINE and Cochrane Center Trials to find all published literature related to AKI in COVID 19 patients including incidence and outcomes Twenty four studies reporting the outcomes of interest were included Across all studies the overall sample size of COVID positive children was 1 247 and the median age of this population was 9 1 years old Among COVID positive pediatric patients there was an AKI incidence of 30 51 with only 0 56 of these patients receiving KRT The mortality was 2 55 among all COVID positive pediatric patients The incidence of multisystem inflammatory syndrome in children MIS C among COVID positive patients was 74 29 AKI has shown to be a negative prognostic factor in adult patients with COVID 19 and now also in the pediatric cohort with high incidence and mortality rates Additionally our findings show a strong comparison in epidemiology between adult and pediatric COVID 19 patients however they need to be confirmed with additional data and studies 