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J Pediatr Intensive Care 2016; 05(02): 042-049
DOI: 10.1055/s-0035-1564735
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Acute Renal Failure in the Neonate

Jean-Pierre Guignard
1   Department of Pediatrics, CHUV, Lausanne University, Medical School, Lausanne, Switzerland
,
Uma S. Ali
2   Nephrology Division and PICU, BJ Wadia Hospital for Children, Mumbai, Maharashtra, India
› Author Affiliations
Further Information

Publication History

31 July 2014

15 September 2014

Publication Date:
19 October 2015 (online)

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Abstract

Acute renal failure (ARF) is a common disorder in high-risk neonates. ARF may be oliguric or nonoliguric, the latter having a better prognosis. Risk factors for ARF include prematurity, respiratory and vascular disorders, heart failure, congenital uropathies, and the use of nephrotoxic drugs. Chemical analysis of urine and ultrasounds help differentiate the nature and the type of ARF: prerenal, intrinsic, or postrenal. Conservative management of prerenal forms of ARF consists in carefully restoring cardiac output and controlling fluid and electrolyte balances. Early relief of obstruction is mandatory in severe postrenal forms of ARF. Renal replacement therapy is often necessary when ARF is secondary to intrinsic renal damage: peritoneal dialysis is the treatment of choice. Hemodialysis and continuous venovenous hemofiltration may be used in specific cases. Overall prognosis of ARF depends on the nature and severity of the renal injury that has led to renal failure.

Keywords

neonatal nephrology - neonatal renal failure - asphyxic renal failure - nephrotoxic drugs
 

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