Related Experiment Video
Updated: Mar 26, 2026
Nephrotoxin Microinjection in Zebrafish to Model Acute Kidney Injury
Published on: July 17, 2016
The path to chronic kidney disease following acute kidney injury: a neonatal perspective
Swasti Chaturvedi1, Kar Hui Ng1,2, Cherry Mammen3
1Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore.
Insights
Neonatal acute kidney injury (AKI) poses a high risk for developing chronic kidney disease (CKD) later in life. Early monitoring of infants with AKI is crucial for detecting CKD in its initial stages.
Area of Science:
- Neonatology
- Nephrology
- Pediatric Critical Care
Background:
- Hospitalized critically ill neonates face a significant risk of acute kidney injury (AKI), impacting both term and premature infants.
- Survivors of neonatal AKI exhibit high rates of chronic kidney disease (CKD), with proposed mechanisms including nephron loss and maladaptive repair.
- Factors like prematurity and low birth weight may independently influence CKD development or modify the AKI-CKD relationship.
Purpose of the Study:
- To highlight the high risk of chronic kidney disease (CKD) in neonatal survivors of acute kidney injury (AKI).
- To address the heterogeneity in current literature regarding AKI and CKD definitions in neonates.
- To emphasize the need for standardized definitions and further research to accurately assess the AKI-CKD relationship.
Main Methods:
- Review of observational studies examining AKI and CKD in neonatal populations.
- Analysis of proposed mechanisms for CKD progression post-AKI, including nephron loss and vascular factors.
- Identification of confounding factors such as prematurity and low birth weight.
Main Results:
- High rates of CKD are observed in survivors of neonatal AKI.
- Heterogeneity in AKI definitions and CKD outcomes complicates assessment of the AKI-CKD link.
- Prematurity and low birth weight are associated with CKD, potentially modifying the AKI-CKD relationship.
Conclusions:
- Neonatal AKI is a significant risk factor for developing CKD.
- Standardized definitions and larger prospective studies are essential for quantifying CKD risk after neonatal AKI.
- Longitudinal follow-up is recommended for all neonates with AKI to enable early CKD detection.
Abstract:
The risk of acute kidney injury (AKI) in hospitalized critically ill neonatal populations without primary renal disease continues to be high, in both term and premature infants. Observational studies have revealed high rates of chronic kidney disease (CKD) in survivors of neonatal AKI. Proposed mechanisms underlying the progression of CKD following AKI include nephron loss and hyperfiltration, vascular insufficiency and maladaptive repair mechanisms. Other factors, including prematurity and low birth weight, have an independent relationship with the development of CKD, but they may also be positive effect modifiers in the relationship of AKI and CKD. The large degree of heterogeneity in the literature on AKI in the neonatal population, including the use of various AKI definitions and CKD outcomes, has hampered the medical community's ability to properly assess the relationship of AKI and CKD in this vulnerable population. Larger prospective cohort studies with control groups which utilize recently proposed neonatal AKI definitions and standardized CKD definitions are much needed to properly quantify the risk of CKD following an episode of AKI. Until there is further evidence to guide us, we recommend that all neonates with an identified episode of AKI should have an appropriate longitudinal follow-up in order to identify CKD at its earliest stages.
Related Concept Videos
01:29Acute Kidney Injury II: Pathophysiology
01:29Acute Kidney Injury III: Clinical Manifestations
01:22Acute Kidney Injury I: Introduction
01:27Acute Pyelonephritis I: Introduction
01:25Chronic Kidney Disease I: Introduction
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention