Nada Arwa, Bonachea Elizabeth M, Askenazi David J
Division of Pediatric Nephrology, Faculty of Medicine, University of Alexandria, ElShatby, Alexandria, Egypt; Division of Pediatric Nephrology, The University of Tennessee Health Science Center, Le Bonheur Children's Hospital, 49 North Dunlap, Suite 326, Memphis, TN 38105, USA.
Department of Pediatrics, The Ohio State University, Section of Neonatology, Nationwide Children's Hospital, Columbus, OH, USA.
Semin Fetal Neonatal Med. 2017 Apr;22(2):90-97. doi: 10.1016/j.siny.2016.12.001. Epub 2016 Dec 26.
Acute kidney injury (AKI) is an under-recognized morbidity of neonates; the incidence remains unclear due to the absence of a unified definition of AKI in this population and because previous studies have varied greatly in screening for AKI with serum creatinine and urine output assessments. Premature infants may be born with less than half of the nephrons compared with term neonates, predisposing them to chronic kidney disease (CKD) early on in life and as they age. AKI can also lead to CKD, and premature infants with AKI may be at very high risk for long-term kidney problems. AKI in neonates is often multifactorial and may result from prenatal, perinatal, or postnatal insults as well as any combination thereof. This review focuses on the causes of AKI, the importance of early detection, the management of AKI in neonates, and long-term sequela of AKI in neonates.
急性肾损伤（AKI）是一种在新生儿中未得到充分认识的疾病；由于该人群中缺乏AKI的统一定义，且以往研究在通过血清肌酐和尿量评估筛查AKI方面差异很大，其发病率仍不明确。与足月儿相比，早产儿出生时的肾单位可能不到足月儿的一半，这使他们在生命早期及随着年龄增长易患慢性肾脏病（CKD）。AKI也可导致CKD，患有AKI的早产儿可能面临长期肾脏问题的极高风险。新生儿AKI通常是多因素的，可能由产前、围产期或产后损伤以及这些损伤的任何组合引起。本综述重点关注新生儿AKI的病因、早期检测的重要性、新生儿AKI的管理以及新生儿AKI的长期后遗症。
