Acute kidney injury (AKI), formerly referred to as acute renal failure (ARF), is defined as an abrupt reduction in kidney function measured by a rapid decline in glomerular filtration rate. AKI is an important contributing factor to the morbidity and mortality of critically ill neonates.
AKI results in the disturbance of the following renal physiological functions:
- Impairment of nitrogenous waste product excretion
- Loss of water and electrolyte regulation
- Loss of acid-base regulation
An overview of AKI in neonates is presented in this topic review. The clinical presentation, evaluation, diagnosis, prevention, and management of AKI in children are presented separately. (See "Acute kidney injury in children: Clinical features, etiology, evaluation, and diagnosis" and "Prevention and management of acute kidney injury (acute renal failure) in children".)
NORMAL NEONATAL RENAL FUNCTION
Glomerular filtration rate — The mean glomerular filtration rate (GFR) for a full term infant is about 26 mL/min per 1.73 m2. GFR doubles by one to two weeks of age to 54 mL/min per 1.73 m2.