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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Acute renal failure in neonates: A prospective study
H M Al-Idressy1, O B Abdel Basit, K N Haque
1Department of Pediatrics, King Khalid University Hospital, Riyadh, Saudi Arabia.
Annals of Saudi Medicine
|May 1, 1991
Summary
Neonatal acute renal failure affects 3.6% of NICU babies, often caused by hypotension and prematurity. Diagnostic indices were unreliable, and mortality was high, but survivors showed no lasting kidney issues.
Area of Science:
- Neonatology
- Pediatric Nephrology
- Critical Care Medicine
Background:
- Neonatal acute renal failure (NARF) is a serious condition in Neonatal Intensive Care Units (NICUs).
- Identifying causes and reliable diagnostic markers for NARF is crucial for infant outcomes.
- Premature and low-birth-weight infants are particularly vulnerable.
Purpose of the Study:
- To determine the causes, clinical course, and outcomes of acute renal failure in neonates.
- To evaluate the reliability of renal indices in differentiating intrinsic from prerenal acute renal failure.
- To identify clinical indicators for diagnosing and predicting the prognosis of NARF.
Main Methods:
- Prospective study of 603 neonates admitted to the NICU.
- Analysis of 22 neonates who developed acute renal failure.
- Assessment of etiological factors including hypotension, respiratory distress syndrome, sepsis, and asphyxia.
- Evaluation of renal indices: urine-to-plasma osmolality, fractional excretion of sodium, and renal failure index.
Main Results:
- The incidence of NARF was 3.6%.
- Common causes included hypotension (86%), respiratory distress syndrome (41%), sepsis (32%), and asphyxia (27%).
- Fifteen neonates had intrinsic renal failure and seven had prerenal failure.
- Renal indices were unreliable in distinguishing between intrinsic and prerenal failure.
- Mortality rate was high at 77%.
Conclusions:
- Hypotension, prematurity, and sepsis are significant contributors to NARF.
- Current renal indices are not sufficiently reliable for differentiating NARF types in neonates.
- Despite high mortality, survivors without congenital urinary tract anomalies showed no residual renal impairment.
- Further research is needed to identify reliable diagnostic and prognostic clinical indices for NARF, especially in vulnerable infants.
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