Renal Oxygenation Measured by Near-Infrared Spectroscopy in Neonates

Area of Science:

• Neonatal physiology
• Medical technology assessment
• Pediatric nephrology

Background:

• Acute kidney injury (AKI) affects 30% of neonatal intensive care unit (NICU) infants, increasing mortality.
• Current AKI diagnostics are insensitive to early-stage nephron damage.
• Near-infrared spectroscopy (NIRS) offers noninvasive renal oxygenation monitoring for early AKI detection.

Purpose of the Study:

• To review NIRS principles for measuring renal oxygenation.
• To evaluate NIRS use in NICU infants for AKI prediction and identification.

Main Methods:

• Systematic literature search of PubMed and CINHAL.
• Focused on renal NIRS studies in preterm and term infants in the NICU.

Main Results:

• 34 studies were analyzed.
• In term infants, reduced renal oxygenation correlated with AKI and predicted survival.
• Findings in preterm infants were mixed, with associations to AKI but also conflicting results in specific conditions.

Conclusions:

• Renal NIRS shows promise for noninvasively detecting kidney hypoperfusion before conventional AKI markers appear.
• Further research is required due to sparse normative data, undefined ischemia thresholds, and lack of clinical treatment consensus.