Pandey Vishal, Kumar Deepak, Vijayaraghavan Prashant, Chaturvedi Tushar, Raina Rupesh
Department of Pediatrics and Neonatology, University of Kansas Hospital, Kansas City, KS, USA.
Department of Pediatrics and Neonatology, MetroHealth Medical Center, Cleveland, OH, USA.
J Renal Inj Prev. 2016 Oct 29;6(1):1-11. doi: 10.15171/jrip.2017.01. eCollection 2017.
Treating acute kidney injury (AKI) in newborns is often challenging due to the functional immaturity of the neonatal kidney. Because of this physiological limitation, renal replacement therapy (RRT) in this particular patient population is difficult to execute and may lead to unwanted complications. Although fluid overload and electrolyte abnormalities, as seen in neonatal AKI, are indications for RRT initiation, there is limited evidence that RRT initiated in the first year of life improves long-term outcome. The underlying cause of AKI in a newborn patient should determine the treatment strategies to restore appropriate renal function. However, our understanding of this common clinical condition remains limited, as no standardized, evidence-based definition of neonatal AKI currently exists. Non-dialytic management of AKI in these patients may restore appropriate renal function to these patients without exposure to complications often encountered with RRT.
由于新生儿肾脏功能不成熟，治疗新生儿急性肾损伤（AKI）往往具有挑战性。由于这种生理限制，在这一特定患者群体中进行肾脏替代治疗（RRT）很难实施，并且可能导致不良并发症。虽然新生儿急性肾损伤中出现的液体超负荷和电解质异常是开始肾脏替代治疗的指征，但仅有有限的证据表明在生命的第一年开始进行肾脏替代治疗能改善长期预后。新生儿患者急性肾损伤的潜在病因应决定恢复适当肾功能的治疗策略。然而，我们对这种常见临床病症的了解仍然有限，因为目前尚无标准化的、基于证据的新生儿急性肾损伤定义。对这些患者进行急性肾损伤的非透析管理可能使他们恢复适当的肾功能，而不会面临肾脏替代治疗中经常遇到的并发症。
