Author/Authors :
Pandey, Vishal Department of Pediatrics and Neonatology - University of Kansas Hospital, Kansas City, KS, USA , Kumar, Deepak Department of Pediatrics and Neonatology - MetroHealth Medical Center, Cleveland, OH, USA , Vijayaraghavan, Prashant Division of Nephrology - Department of Internal Medicine and Research Cleveland Clinic Akron General, Akron, OH, USA , Chaturvedi, Tushar Division of Nephrology - Department of Internal Medicine and Research Cleveland Clinic Akron General, Akron, OH, USA , Raina, Rupesh Division of Nephrology - Department of Internal Medicine and Research Cleveland Clinic Akron General, Akron, OH, USA
Abstract :
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.
