Vishal Pandey
1, Deepak Kumar
2, Prashant Vijayaraghavan
3, Tushar Chaturvedi
3, Rupesh Raina
3,4*1 Department of Pediatrics and Neonatology, University of Kansas Hospital, Kansas City, KS, USA
2 Department of Pediatrics and Neonatology, MetroHealth Medical Center, Cleveland, OH, USA
3 Division of Nephrology, Department of Internal Medicine and Research Cleveland Clinic Akron General, Akron, OH, USA
4 Akron Children’s Hospital, Cleveland, 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.
Implication for health policy/practice/research/medical education:
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 in this particular patient population is difficult to execute and may lead to unwanted complications.
Please cite this paper as: Pandey V, Kumar D, Vijayaraghavan P, Chaturvedi T, Raina R. Non-dialytic management of acute kidney injury in newborns. J Renal Inj Prev. 2017;6(1):1-11. DOI: 10.15171/jrip.2017.01.