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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
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Management of Acute Kidney Injury in Extremely Low Birth Weight Infants

Aoife Branagan1,2, Caoimhe S Costigan3, Maria Stack1,3

  • 1Paediatrics, Trinity Research in Childhood Centre (TRICC), Trinity College Dublin, Dublin, Ireland.

Frontiers in Pediatrics
|April 18, 2022
PubMed

Insights

Acute kidney injury (AKI) affects up to 50% of extremely low birth weight (ELBW) infants in the NICU. Early recognition and management are crucial, despite diagnostic challenges, to prevent long-term complications.

Area of Science:

  • Neonatalogy
  • Nephrology
  • Pediatric Critical Care

Background:

  • Acute kidney injury (AKI) is prevalent in neonatal intensive care units (NICUs).
  • Extremely low birth weight (ELBW) infants (<1,000 g) face heightened risks due to comorbidities like prematurity and intrauterine growth restriction.
  • Up to 50% of ELBW infants experience AKI during their NICU stay.

Purpose of the Study:

  • To review the current understanding of AKI in ELBW infants.
  • To highlight diagnostic challenges and the lack of established management guidelines.
  • To provide evidence-based recommendations for AKI care in this vulnerable population.

Main Methods:

  • Literature review summarizing existing studies on AKI in ELBW infants.
  • Analysis of diagnostic criteria and their limitations in neonates.
  • Synthesis of current management strategies and proposed interventions.

Main Results:

  • AKI definition in ELBW infants is imperfect, leading to under-recognition.
  • No established guidelines exist for AKI management in ELBW infants, causing practice variability.
  • Key management strategies include fluid balance monitoring, nephrotoxic medication review, electrolyte management, nutritional support, and judicious use of diuretics/dialysis.

Conclusions:

  • AKI is a significant concern for ELBW infants, requiring vigilant monitoring.
  • Improved diagnostic criteria and standardized management guidelines are needed.
  • Proactive management focusing on fluid balance, medication safety, and supportive care can mitigate AKI impact.

Keywords:
acute kidney injuryextremely low birth weighthypertensionpreterm infantrenal biomarkers

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