Sweetman Deirdre U
Department of Neonatology, National Maternity Hospital, Holles Street, Dublin 2, Ireland.
Early Hum Dev. 2017 Feb;105:57-61. doi: 10.1016/j.earlhumdev.2016.12.006. Epub 2017 Jan 11.
Neonatal acute kidney injury is common, in part due to incomplete renal maturation and also due to frequent exposure to risk factors for acute kidney injury such as perinatal asphyxia, extracorporeal-membrane-oxygenation, cardiac surgery, sepsis, prematurity and nephrotoxicity. However the current method by which acute kidney injury is diagnosed is sub-optimal and not universally accepted which impairs the accurate estimation of the true incidence of neonatal acute kidney injury. Serum Cystatin-C, urinary NGAL, KIM-1 and IL-18 are promising neonatal acute kidney injury biomarkers however the diagnosis of acute kidney injury remains serum creatinine/urine output-based in many studies. Emerging biomarkers which require further study in the neonatal population include netrin-1 and EGF. Increased awareness amongst clinicians of nephrotoxic medications being a modifiable risk factor for the development of neonatal acute kidney injury is imperative. The burden of chronic kidney failure following neonatal acute kidney injury is unclear and requires further study.
新生儿急性肾损伤很常见，部分原因是肾脏发育不完全，还因为经常暴露于急性肾损伤的风险因素，如围产期窒息、体外膜肺氧合、心脏手术、败血症、早产和肾毒性。然而，目前诊断急性肾损伤的方法并不理想，也未被普遍接受，这影响了对新生儿急性肾损伤真实发病率的准确估计。血清胱抑素C、尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、肾损伤分子-1（KIM-1）和白细胞介素-18是很有前景的新生儿急性肾损伤生物标志物，然而在许多研究中，急性肾损伤的诊断仍基于血清肌酐/尿量。在新生儿群体中需要进一步研究的新兴生物标志物包括网蛋白-1和表皮生长因子（EGF）。临床医生必须提高对肾毒性药物是新生儿急性肾损伤发生的一个可改变风险因素的认识。新生儿急性肾损伤后慢性肾衰竭的负担尚不清楚，需要进一步研究。
