Acute kidney failure in preterm infants and neonates

Background: Numerous excellent studies during recent years focused on acute kidney failure in neonates. Objective: This review article gives an overview on the current study situation on acute kidney failure (AKI) in preterm infants and neonates. These findings comprise data on the incidence, risk factors and possible forms of treatment as well as consequences of postnatal acute kidney failure further on in life. Material and methods: A literature search was carried out in PubMed with a special focus on current treatment recommendations and guidelines. Results: As already shown for other age groups, acute kidney failure is also a frequent finding in preterm infants and neonates especially during intensive medical care and is an independent risk factor for increased mortality and longer duration of hospitalization. Risk factors differ between early (within the first 7 days of life) and late acute kidney failure. In addition to avoidance of nephrotoxic medication, the administration of caffeine citrate was identified as an effective protective factor in preterm infants. Discussion: The increasing research activities on acute kidney failure in neonates could not only identify risk factors and protective factors but also increased awareness for this condition. The impact of postnatal acute kidney injury on the risk of a chronic kidney disease during adolescence and adulthood needs to be determined in further long-term studies. In the context of renal programming, prematurity per se as well as other perinatal risk factors have already been shown to substantially increase the risk of chronic kidney disease in later life.