Neonatal Acute Kidney Injury: Diagnostic and Therapeutic
Challenges

Bakr, Ashraf M.; Eid, Riham; Allam, Nahla; Saleh, Hisham Aly

doi:10.17554/j.issn.2410-0579.2018.04.26

Cited by 5 publications

(6 citation statements)

References 40 publications

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“…Perinatal asphyxia is, after septic shock, the second cause of renal failure in newborns. 2,3,6,8,10,11 In this context, the kidney remains the most affected organ after the brain. The occurrence of renal damage is correlated with the severity of the neurological damage.…”

Section: Discussionmentioning

confidence: 99%

“…3,[5][6][7] In addition, the evolution of neonatal acute renal failure is often pejorative due to high short-term mortality and the increased risk of occurrence of renal sequelae including long-term chronic renal failure. [2][3][4]6,[8][9][10][11][12][13][14] Cases were defined as all newborns hospitalized and presenting an increase in serum creatinine (taken beyond the 12th hour of life) defined either: by a value >1.5 mg/dl (or 133 µmol/l) on a single dosage or according to the kidney disease improving global outcome (KDIGO) criteria.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for acute neonatal renal failure

Rambeloson

Samena

Rabevazaha

et al. 2022

Int J Contemp Pediatr

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Background: Acute neonatal renal failure is a health problem. Its risk factors and its clinical and evolutionary profile remain unknown in the Malagasy context. The main objective of this study was to determine its risk factors.Methods: This was a 14 month, single-center, retrospective, case-control study (November 2018 to December 2019). The cases were represented by newborns hospitalized and presenting an hypercreatininaemia (value >133 µmol/l or according to the KDIGO criteria) and controls by neonates without an hypercreatininaemia. One case was matched to 2 controls.Results: We included 75 cases. The prevalence was 14.5%. The mean age was 5±6.78 days (p=0.006). The sex ratio was 1.27. The mean gestational age was 36.69±3.84 WA (p=0.66). The mean serum creatinine value was 180.32 µmol/l. Thirty-one newborns had died (41.3%). The risk factors were: sepsis (OR=9.37, p≤0.001, CI=3.03, 33.5), perinatal asphyxia SARNAT 2 (OR=4.52, p=0.007, CI=1.53, 13.8) and SARNAT 3 (OR=7.90, p=0.021, CI=1.56, 60.4), increased weight loss (OR=4.04, p=0.006, CI=1.51, 11.2) and respiratory distress (OR=2.76, p=0.005, CI=1.37, 5.77).Conclusions: The risk factors were consistent with the data in the literature. Better management of parturients and the newborn as well as monitoring of serum creatinine in hospitalised newborns are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for acute neonatal renal failure

Rambeloson

Samena

Rabevazaha

et al. 2022

Int J Contemp Pediatr

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“…Also, about the definition of stage 3, in older children and adults, it is considered 3 times increase in baseline creatinine or creatinine acutely greater than 4.0mg/dL, and in neonates, an increase of 3 times in basal creatinine or creatinine acutely greater than 2.5mg/ dL (Table 3). 20,21 Serial dosage of creatinine and continuous monitoring of diuresis is recommended. Besides urinalysis, must request the complete blood count, electrolyte dosage, blood gas analysis, and coagulogram.…”

Section: Early Diagnosismentioning

confidence: 99%

“…Classification of Neonatal Acute Kidney Injury (Kidney Disease Improving Global Outcomes -KDIGO) 20,21. …”

mentioning

confidence: 99%

Acute Kidney Injury in Children

Bresolin¹

2021

SOJPCN

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Recent literature data has shown that acute kidney injury (AKI) is a common occurrence in critically ill children and that it is associated with high rates of morbidity and mortality, even after adjusting for other risk factors. In addition, it can result in long-term sequelae translated by the development of arterial hypertension, microalbuminuria and chronic renal dysfunction. High degree of suspicion, early diagnosis based on the recognition of patients at risk and the use of new criteria for the diagnosis and classification of AKI and, whenever possible, using the new biomarkers can positively alter the prognosis of these patients. Although there is still no specific treatment for AKI, it is recommended to focus on the immediate institution of preventive measures in order to maintain renal hemodynamics, early treatment of septic patients, elimination of exogenous nephrotoxins, recognition and management of patients with AKI secondary to high levels of endotoxins, control and normalization of volume after the initial phase of fluid resuscitation, sufficient nutritional support, and recognition and treatment of the underlying causes are necessary. Patients that fail with conservative care will need renal replacement therapy.

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“…Prerenal AKI (if treatment is started on time) and postrenal AKI (if distal urinary tract obstruction is removed in time) have a good prognosis. Renal AKI with residual renal failure (decreased glomerular filtration, tubular dysfunction, or stunted renal growth) or permanent loss of renal function and development of terminal renal failure has a poor prognosis [8,9].…”

Section: Introductionmentioning

confidence: 99%

Follow Up of Children With Kidney Injury in Neonatal Age

Timovska

Bojadzieva

Mangjukovska

2021

JMS

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Long-term follow-up of patients with acute kidney injury (AKI) has shown that glomerular filtration and tubular function are still normal. Renal blood flow remains permanently impaired, suggesting that there is still some irreversible loss of nephrons and that glomerular filtration is maintained by hypertrophy of the remaining nephrons.The aim of the study was to identify signs of chronic kidney diseases in children with kidney injury in neonatal age.The study was designed as a prospective investigation conducted in the period of two years, which included 50 neonates with kidney injury hospitalized in NICU, University Clinic for Pediatric Diseases in Skopje. Due to the potential risk of developing chronic renal failure by the end of the first year of life, in 26 children with kidney injury in neonatal age were evaluated growth and development, arterial tension, and renal function. The material was statistically analyzed using methods of descriptive statistics.Of the total of 50 neonates with documented AKI, we followed 26 neonates because of the risk of disease progression to chronic renal failure. According to the results from the percentage growth curves, 85% of children had a normal finding, while 15% were obese children, with weighing between 85 and 95 percentiles. 96% of children had arterial tension with reference values according to age group, and only one child had prehypertension. We registered microproteinuria in 7.6% of children, and there were no hematuria findings.Most of the monitored children had proper renal function, which was probably due to the predominance of prerenal AKI, associated with a better prognosis. The follow-up period of one year was short and in order to obtain more reliable results, long-term controlled monitoring is required, which would last several years.

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Neonatal Acute Kidney Injury: Diagnostic and Therapeutic Challenges

Abstract: critical item in neonatal care, the special precautions regarding drugs use in neonates and renal replacement therapy in neonates which is not only technically difficult, but also associated with high rates of complications all yields AKI management in neonates to be a great challenge.

Cited by 5 publications

References 40 publications

Risk factors for acute neonatal renal failure

Risk factors for acute neonatal renal failure

Acute Kidney Injury in Children

Follow Up of Children With Kidney Injury in Neonatal Age

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