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Review
. 2024 Jun 13;13(12):3446.
doi: 10.3390/jcm13123446.

Acute Kidney Injury in Neonatal Intensive Care Unit: Epidemiology, Diagnosis and Risk Factors

Valeria Chirico  1 , Antonio Lacquaniti  2 , Filippo Tripodi  1 , Giovanni Conti  1 , Lucia Marseglia  3 , Paolo Monardo  2 , Eloisa Gitto  3 , Roberto Chimenz  1
Affiliations
Review

Acute Kidney Injury in Neonatal Intensive Care Unit: Epidemiology, Diagnosis and Risk Factors

Valeria Chirico et al. J Clin Med. .

Abstract

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.

Keywords: acute kidney injury; neonatal intensive care unit; nephrotoxic drugs; renal biomarkers; renal injury; sepsis.

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Conflict of interest statement

The authors declare no conflicts of interest.

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