Stealing nephrons-a review on how patent ductus arteriosus physiology impacts neonatal kidney health

Abstract

Adverse short- and long-term kidney outcomes are increasingly recognized as sequelae of NICU care, oftentimes of multifactorial origin and in the setting of a patent ductus arteriosus (PDA). Many studies have reviewed the interactions between the PDA and the brain, intestine, and lungs, but few have specifically reviewed the potential influence of the PDA on the kidney. This review describes the current breadth of literature as it relates to the pathophysiologic interplay between the PDA and the kidneys, as well as how PDA intervention may influence kidney health while neonates are still in the NICU and after discharge. We also discuss novel methods of monitoring these interactions with biomarkers and near infrared spectroscopy, and highlight areas with a dearth of evidence to promote future study.