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Semin Fetal Neonatal Med. 2017 Apr;22(2):90-97. doi: 10.1016/j.siny.2016.12.001. Epub 2016 Dec 26.

Acute kidney injury in the fetus and neonate.

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Division of Pediatric Nephrology, Faculty of Medicine, University of Alexandria, ElShatby, Alexandria, Egypt; Division of Pediatric Nephrology, The University of Tennessee Health Science Center, Le Bonheur Children's Hospital, 49 North Dunlap, Suite 326, Memphis, TN 38105, USA.
Department of Pediatrics, The Ohio State University, Section of Neonatology, Nationwide Children's Hospital, Columbus, OH, USA.
Department of Pediatrics, Division of Pediatric Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address:


Acute kidney injury (AKI) is an under-recognized morbidity of neonates; the incidence remains unclear due to the absence of a unified definition of AKI in this population and because previous studies have varied greatly in screening for AKI with serum creatinine and urine output assessments. Premature infants may be born with less than half of the nephrons compared with term neonates, predisposing them to chronic kidney disease (CKD) early on in life and as they age. AKI can also lead to CKD, and premature infants with AKI may be at very high risk for long-term kidney problems. AKI in neonates is often multifactorial and may result from prenatal, perinatal, or postnatal insults as well as any combination thereof. This review focuses on the causes of AKI, the importance of early detection, the management of AKI in neonates, and long-term sequela of AKI in neonates.


Acute kidney injury; Kidney adaptation; Neonate; Renal replacement therapy

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