Management of acute renal failure in newborns
Management of acute renal failure in newborns
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DOI：
10.1007/s004670050068
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发表时间：
2000-09-01
影响因子：
3
通讯作者：
Guignard, JP
中科院分区：
文献类型：
--
作者：
Gouyon, JB;Guignard, JP
急性肾功能衰竭（ARF）是新生儿重症监护病房常见的临床疾病。在生命最初几天使用血浆肌酐浓度诊断ARF时应谨慎。静脉输液挑战可以区分肾脏衰竭和内在肾功能衰竭。所有与新生儿低血容量、低氧血症和低血压相关的临床情况都可能导致肾功能不全，主要原因是围产期缺氧缺血和败血症。初期治疗主要依靠纠正低血压、酸中毒、低氧血症，以减轻肾脏血管收缩，改善肾脏灌注。必要时，主要的肾脏替代疗法通常是腹膜透析，即使在一些新生儿重症监护病房有熟练的医疗和护理人员可以安全地进行血液滤过和血液滤过。
Acute renal failure (ARF) is a frequent clinical condition in neonatal intensive care units. Plasma creatinine concentrations should be used with some caution for ARF diagnosis in the first days of life. An intravenous fluid challenge allows differentiation of prerenal failure and intrinsic renal failure. All clinical conditions associated with hypovolemia, hypoxemia, and hypotension in the newborn infant may lead to renal insufficiency, the leading causes being perinatal anoxia-ischemia and sepsis. The initial treatment mainly relies on correction of hypotension, acidosis, and hypoxemia, in order to reduce renal vasoconstriction and improve renal perfusion. If necessary, the main renal replacement therapy is usually peritoneal dialysis even if skilled medical and nursing personnel are available in some neonatal intensive care units to perform hemofiltration and hemodiafiltration safely.