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Review
. 2022 Mar 30:10:867715.
doi: 10.3389/fped.2022.867715. eCollection 2022.

Management of Acute Kidney Injury in Extremely Low Birth Weight Infants

Aoife Branagan  1   2 , Caoimhe S Costigan  3 , Maria Stack  1   3 , Cara Slagle  4   5 , Eleanor J Molloy  1   2   6   7
Affiliations
Review

Management of Acute Kidney Injury in Extremely Low Birth Weight Infants

Aoife Branagan et al. Front Pediatr. .

Abstract

Acute kidney injury (AKI) is a common problem in the neonatal intensive care unit (NICU). Neonates born at <1,000 g (extremely low birth weight, ELBW) are at an increased risk of secondary associated comorbidities such as intrauterine growth restriction, prematurity, volume restriction, ischaemic injury, among others. Studies estimate up to 50% ELBW infants experience at least one episode of AKI during their NICU stay. Although no curative treatment for AKI currently exists, recognition is vital to reduce potential ongoing injury and mitigate long-term consequences of AKI. However, the definition of AKI is imperfect in this population and presents clinical challenges to correct identification, thus contributing to under recognition and reporting. Additionally, the absence of guidelines for the management of AKI in ELBW infants has led to variations in practice. This review summarizes AKI in the ELBW infant and includes suggestions such as close observation of daily fluid balance, review of medications to reduce nephrotoxic exposure, management of electrolytes, maximizing nutrition, and the use of diuretics and/or dialysis when appropriate.

Keywords: acute kidney injury; extremely low birth weight; hypertension; preterm infant; renal biomarkers.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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