新生兒急性腎損傷

Acute Kidney Injury in Newborns

新生兒急性腎損傷常見於新生兒加護中心，一旦新生兒發生急性腎損傷則易轉變成慢性腎臟病，影響新生兒生長發展甚鉅，甚或導致死亡。新生兒腎臟生理功能會隨妊娠週數發生變化，出生後新生兒子宮外適應狀況更會影響腎功能的轉變及調節，尤其早產兒因其腎臟發育未完全，更增加其發生急性腎損傷的機率及照護難度。因此有必要了解新生兒急性腎損傷的定義、危險因子、評估項目和照護處置，如維持體液及水份、電解質的穩定及腎臟替代治療的應用等。健康照護者須依據新生兒出生後的生理變化審慎評估，並且運用適當生物指標盡早發現新生兒急性腎損傷，盡早給予適當照護，以達預防或降低新生兒急性腎損傷的機率，以提升新生兒照護品質。

Neonatal acute kidney injury is a common clinical condition encountered in neonatal intensive care units. Acute kidney injury in newborns is associated with a poor prognosis and significantly increased risks of mortality and chronic kidney disease. Neonatal kidney function changes with gestation and neonatal extra-uterine adaptation affects the transformation and regulation of renal functions. In particular, premature infants are more likely to develop acute kidney injury due to incomplete kidney development, which increases the difficulty of care. It is necessary to understand the definition and risk factors of acute kidney injury in neonates as well as treatment options, which include maintai-ning body fluid and water balance, stabilizing electrolyte levels, and implementing renal replacement therapy. Healthcare providers must carefully evaluate a newborn's physiological changes after birth and use relevant biological indicators to detect acute kidney injury as early as possible in order to prevent or reduce the risk of acute kidney injury and provide appropriate care to improve the quality of newborn care.