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Neonatal Acute Kidney Injury

  • Indrani Bhattacharjee
  • Marissa J. DeFreitas
  • Maroun Mhanna
  • Carolyn AbitbolEmail author
Chapter

Abstract

Neonatal acute kidney injury (nAKI) is highly prevalent but the definition of nAKI remains nebulous. This is because we rely on serum creatinine (SCr) for the estimation of kidney function which is an indirect measure of muscle mass and the maternal placental transfer of SCr in the early post-natal period. Similarly, the physiological transition into the extra-uterine environment should result in a natural improvement in neonatal renal function from 25% to at least 60% of adult renal function within the first post-natal week. This should lead to a natural and steady decline in the SCr from birth to discharge. Neonatal AKI may be defined as a rise in SCr of >0.3 mg/dL, a peak in SCr ≥1.5 mg/dL and/or a “nadir” SCr at discharge ≥0.5 mg/dL. Importantly, infants born preterm and/or small for gestational age are more vulnerable to nAKI. Diagnosis, early medical intervention and longterm follow-up are essential for these individuals to avert the likely progression to chronic kidney disease including hypertension and cardiorenal disease with shortened longevity.

Keywords

Neonatal Acute kidney injury Nephrogenesis Prematurity Nephron endowment Postnatal adaptation Serum creatinine Estimated glomerular filtration rate 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Indrani Bhattacharjee
    • 1
  • Marissa J. DeFreitas
    • 2
  • Maroun Mhanna
    • 3
  • Carolyn Abitbol
    • 4
    Email author
  1. 1.NeonatologyCase Western Reserve University, Neonatal Perinatal Medicine, MetroHealth Medical Center/Cleveland Clinic FoundationClevelandUSA
  2. 2.Clinical Pediatrics, Department of Pediatrics/Division of Pediatric NephrologyHoltz Children’s Hospital/Jackson Memorial HospitalMiamiUSA
  3. 3.PediatricsCase Western Reserve University, Pediatric Critical Care and Neonatal Perinatal Medicine, MetroHealth Medical CenterClevelandUSA
  4. 4.Pediatrics, Pediatric DialysisUniversity of Miami/Holtz Children’s HospitalMiamiUSA

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