J Korean Soc Neonatol.  2010 Nov;17(2):168-180.

Treatment of Acute Renal Failure in Neonate

• Lee JA

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.

Keyword

Acute renal failure; Acute kidney injury; Treatment; Neonate

MeSH Terms

Acute Kidney Injury
Diuretics
Hemofiltration
Humans
Indomethacin
Infant, Newborn
Kidney
Nutritional Support
Peritoneal Dialysis
Renal Dialysis
Renal Replacement Therapy
Stem Cells
Diuretics
Indomethacin