Kidney Injury in the Neonate

Abstract Acute kidney injury (AKI) is very common in the neonatal period occurring in approximately 6% to 24% of newborns in the ICU. Emerging data suggest that AKI lends itself to a higher mortality independent of all other risk factors. AKI can have multiple etiologies and is classified into prerenal, intrinsic, and postrenal injury. Premature and small-for-gestational-age infants are at particular risk for the development of AKI and are also at risk for the development of hypertension, proteinuria, and chronic kidney disease (CKD) in the long term due to lower nephron mass. Renal replacement therapy in the form of peritoneal dialysis, hemodialysis, or continuous venovenous hemodialysis may be indicated for the use of endogenous and exogenous toxin removal and to maintain fluid, electrolyte, and acid-base balance.