Update on acute kidney injury in the neonate.
OBJECTIVE
Acute kidney injury (AKI) is associated with increased risk of morbidity and mortality in critically ill children and adults. Neonates remain an understudied group, although previous evidence suggests that this association holds true for them as well.


RESULTS
Attention to the issue of neonatal AKI is increasing. New studies in very low-birthweight infants, infants with congenital heart disease who undergo cardiopulmonary bypass, those who receive extracorporeal membrane oxygenation and infants with perinatal depression continue to demonstrate that AKI is common in neonates and associated with increased risk of morbidity and mortality. Additional advances in the field of neonatal AKI include adaptation of modern, categorical AKI definitions, as well as further evaluation of novel urinary biomarkers (e.g., neutrophil gelatinase-associated lipocalin) in this patient group.


CONCLUSIONS
AKI is an independent risk factor for poor outcomes in critically ill neonates. Our ability to improve outcomes for these patients depends on heightened awareness of this issue both at the bedside as well as in research, commitment to using standardized AKI definitions in order to pool and compare data more effectively and improvement in our diagnostic methods with better AKI biomarkers so that we can identify AKI and intervene much earlier in the disease course.
Division of Nephrology, Dialysis and Transplantation, University of Iowa Children's Hospital, Iowa City, Iowa, USA.
Jennifer G
JG
Jetton
David J
DJ
Askenazi
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D015415:Biomarkers / Q000652:urine; D035843:Biomedical Research / Q000379:methods / Q000639:trends; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D012720:Severity of Illness Index
D015415:Biomarkers