Acute and chronic renal failure in the newborn infant

Abstract

Acute renal failure (ARF) is the consequence of a sudden decrease in glomerular filtration rate with consequent retention of nitrogen waste products and disturbances in water, electrolyte and acid-base balance. Because of its physiological specifics, the premature fetal and neonatal kidneys are particularly vulnerable to common endogenous and exogenous stresses occuring before birth, during delivery or after birth. Clinical studies have shown that 8–24% of all neonates hospitalized in intensive neonatal care units may present with ARF [1–4]. The causes of ARF (Table 125.1) are divided into prerenal (functional), renal (intrinsic) and postrenal (obstructive) causes. Functional pre-renal insufficiency is the most frequent form of ARF. It is preventable if treated early and adequately.