5/17/2023 0 Comments Baby ninja defWith ongoing study, the definition of neonatal AKI has evolved and been standardized, improving our ability to quantify and describe the epidemiology and outcomes associated with neonatal AKI. Furthermore, those who develop neonatal AKI may be at increased risk for the development of chronic kidney disease (CKD). This will include a detailed review of (1) the definition of neonatal AKI, (2) the epidemiology, risk factors, and outcomes associated with neonatal AKI, (3) improvements in risk stratification and diagnostics, (4) mitigation and treatment, (5) advancements in the provision of KST to neonates, and (6) the incidence and risk of subsequent CKD.Īcute kidney injury (AKI) occurs commonly in the neonatal intensive care unit (NICU) and is associated with increase morbidity and mortality. In this comprehensive review we will provide an overview of recent work and advances in the field of neonatal AKI. One of the most exciting developments in neonatal AKI is the advancement in technology to provide KST to neonates with severe AKI. Recent work has also shown that the targeted use of methylxanthines may prevent AKI in a variety of high-risk populations. These efforts also include improving risk stratification (identifying high risk populations, including those with nephrotoxic medication exposure) and diagnostics (novel biomarkers and diagnostic tools). As the impacts of neonatal AKI have become clear, a shift in efforts toward identifying those at highest risk, protocolizing AKI surveillance, improving prevention and diagnosis, and expanding kidney support therapy (KST) for neonates has occurred. This definition has allowed researchers and clinicians to better understand the incidence, risk factors, and outcomes associated with neonatal AKI across populations through a multitude of single-center studies and the seminal, multicenter Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) study. The utilization of the neonatal modified Kidney Disease: Improving Global Outcomes (KDIGO) criteria as the standard definition for neonatal AKI in research and clinical care has driven the advances in our understanding of neonatal AKI over the last 10 years. In the past, AKI had been defined multiple ways. There has also been increasing work suggesting that neonates with AKI are at higher risk of chronic kidney disease (CKD). Neonatal AKI has been shown to be associated with adverse outcomes including increased length of mechanical ventilation, prolonged length of stay, and rise in mortality. In recent years, our knowledge of the incidence and impact of neonatal AKI on outcomes has expanded exponentially. 2Division of Pediatric Nephrology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United StatesĪcute kidney injury (AKI) is a common occurrence in the neonatal intensive care unit (NICU).1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States. Cassandra Coleman 1, Anita Tambay Perez 2, David T.
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