Stapleton F B, Jones D P, Green R S
Pediatric Research Laboratory, LeBonheur Children's Medical Center, University of Tennessee, Memphis 38163.
Pediatr Nephrol. 1987 Jul;1(3):314-20. doi: 10.1007/BF00849230.
Acute renal failure (ARF) occurs in as many as 8% of neonates admitted to neonatal intensive care units. Most often, ARF is recognized because of oliguria (urinary flow rate less than 1 ml/kg per hour) although nonoliguric neonatal ARF is being detected with increasing frequency. Among urinary indices utilized to differentiate oliguric neonatal ARF from prerenal oliguria, a fractional excretion of sodium greater than 3% or a renal failure index (RFI) greater than 3 are helpful in confirming ARF. Such indices must be viewed with caution in very premature infants who may have a physiologically high sodium excretion rate and in neonates with the nonoliguric form of ARF. The mortality of oliguric neonatal renal failure may be as high as 60% in medical ARF and even higher in neonates with congenital heart disease, or with anomalies of the genitourinary system. In contrast, nonoliguric renal failure in neonates has an excellent prognosis. Long-term abnormalities in glomerular filtration rate and in renal tubular function are common in survivors of neonatal ARF.
在入住新生儿重症监护病房的新生儿中，急性肾衰竭（ARF）的发生率高达8%。大多数情况下，ARF是由于少尿（尿流率低于每小时1毫升/千克）而被识别出来的，尽管非少尿型新生儿ARF的检出频率越来越高。在用于区分少尿型新生儿ARF与肾前性少尿的尿液指标中，尿钠排泄分数大于3%或肾衰竭指数（RFI）大于3有助于确诊ARF。对于可能存在生理性高钠排泄率的极早产儿以及非少尿型ARF的新生儿，必须谨慎看待这些指标。在医源性ARF中，少尿型新生儿肾衰竭的死亡率可能高达60%，而在患有先天性心脏病或泌尿生殖系统异常的新生儿中死亡率甚至更高。相比之下，新生儿非少尿型肾衰竭的预后良好。新生儿ARF幸存者中，肾小球滤过率和肾小管功能的长期异常很常见。
