Hospitalized children are experiencing acute kidney injury (AKI) with increasing frequency and are especially vulnerable to its long-term complications. Attempts to leverage novel biomarkers to improve phenotyping of this disease are limited by untargeted testing within broadly selected populations. Here, we review efforts by Basu et al. to use readily available clinical information to identify critically ill children at higher risk for developing severe AKI, who may benefit from novel diagnostic and prognostic information.