| Autor: |
Chirico V; Pediatric Nephrology and Dialysis Unit, University Hospital 'G. Martino', 98124 Messina, Italy., Lacquaniti A; Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy., Tripodi F; Pediatric Nephrology and Dialysis Unit, University Hospital 'G. Martino', 98124 Messina, Italy., Conti G; Pediatric Nephrology and Dialysis Unit, University Hospital 'G. Martino', 98124 Messina, Italy., Marseglia L; Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, 98124 Messina, Italy., Monardo P; Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy., Gitto E; Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, 98124 Messina, Italy., Chimenz R; Pediatric Nephrology and Dialysis Unit, University Hospital 'G. Martino', 98124 Messina, Italy. |
| Abstrakt: |
Acute kidney injury (AKI) is associated with long-term consequences and poor outcomes in the neonatal intensive care unit. Its precocious diagnosis represents one of the hardest challenges in clinical practice due to the lack of sensitive and specific biomarkers. Currently, neonatal AKI is defined with urinary markers and serum creatinine (sCr), with limitations in early detection and individual treatment. Biomarkers and risk factor scores were studied to predict neonatal AKI, to early identify the stage of injury and not the damage and to anticipate late increases in sCr levels, which occurred when the renal function already began to decline. Sepsis is the leading cause of AKI, and sepsis-related AKI is one of the main causes of high mortality. Moreover, preterm neonates, as well as patients with post-neonatal asphyxia or after cardiac surgery, are at a high risk for AKI. Critical patients are frequently exposed to nephrotoxic medications, representing a potentially preventable cause of AKI. This review highlights the definition of neonatal AKI, its diagnosis and new biomarkers available in clinical practice and in the near future. We analyze the risk factors involving patients with AKI, their outcomes and the risk for the transition from acute damage to chronic kidney disease. |
