Treatment of Acute Renal Failure in Neonate.

Lee,  Jin A

doi:2010.17.2.168

Neonatal Med > Volume 17(2); 2010 > Article

Review

Journal of the Korean Society of Neonatology 2010;17(2):168-180.
DOI: https://doi.org/10.5385/jksn.2010.17.2.168 Published online November 15, 2009.

Treatment of Acute Renal Failure in Neonate.

Jin A Lee

Division of Neonatology, Department of Pediatrics, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea. ljinna@snu.ac.kr

Abstract

Acute renal failure (ARF) is common in the neonatal period, however, there are no uniform treatment strategies of ARF. The main treatment strategies are conservative management including medical treatment and the renal replacement therapy. Because ARF in the newborn is commonly acquired by hypoxic ischemic injury and toxic insults, removal of all the offending causes is important. Aminoglycoside, indomethacin, and amphotericin-B are the most common nephrotoxic drugs of ARF. To relieve the possible prerenal ARF, initial fluid challenge can be followed by diuretics. If there is no response, fluid restriction and correction of electrolyte imbalance should begin. Adequate nutritional support and drug dosing according to the pharmacokinetics of such drugs will be difficult problems. Renal replacement therapies may be provided by peritoneal dialysis, intermittent hemodialysis, or hemofiltration. New promising agents, bioartificial kidney, and stem cell will enable us to extend our therapeutic repertoire.

Key Words: Acute renal failure; Acute kidney injury; Treatment; Neonate