Harer Matthew W, Charlton Jennifer R, Tipple Trent E, Reidy Kimberly J
Department of Pediatrics, Division of Neonatology, University of Wisconsin-Madison, Madison, WI, USA.
Department of Pediatrics, Division of Nephrology, University of Virginia Children's Hospital, Box 800386, Charlottesville, VA, USA.
J Perinatol. 2020 Sep;40(9):1286-1295. doi: 10.1038/s41372-020-0656-7. Epub 2020 Apr 10.
As a result of preterm birth, immature kidneys are exposed to interventions in the NICU that promote survival, but are nephrotoxic. Furthermore, the duration of renal development may be truncated in these vulnerable neonates. Immaturity and nephrotoxic exposures predispose preterm newborns to acute kidney injury (AKI), particularly in the low birth weight and extremely preterm gestational age groups. Several studies have associated preterm birth as a risk factor for future chronic kidney disease (CKD). However, only a few publications have investigated the impact of neonatal AKI on CKD development. Here, we will review the evidence linking preterm birth and AKI in the NICU to CKD and highlight the knowledge gaps and opportunities for future research. For neonatal intensive care studies, we propose the inclusion of AKI as an important short-term morbidity outcome and CKD findings such as a reduced glomerular filtration rate in the assessment of long-term outcomes.
由于早产，未成熟的肾脏会在新生儿重症监护病房（NICU）接受促进存活但具有肾毒性的干预措施。此外，这些脆弱新生儿的肾脏发育时间可能会缩短。不成熟以及接触肾毒性物质使早产新生儿易患急性肾损伤（AKI），尤其是低出生体重和极早产孕周组。多项研究已将早产视为未来慢性肾脏病（CKD）的一个风险因素。然而，仅有少数出版物研究了新生儿急性肾损伤对慢性肾脏病发展的影响。在此，我们将综述将NICU中的早产和急性肾损伤与慢性肾脏病联系起来的证据，并突出知识空白以及未来研究的机会。对于新生儿重症监护研究，我们建议将急性肾损伤作为一项重要的短期发病结局纳入，并在长期结局评估中纳入慢性肾脏病的相关发现，如肾小球滤过率降低。
