CAJ | 학술논문

新生儿急性肾损伤（ acute kidney injury，AKI）是新生儿危重症之一，在新生儿重症监护病房中的发生率高达23％，病死率25％～50％。新生儿AKI是指新生儿在低血容量、窒息、休克、缺氧、溶血、低体温等各种不利因素导致肾功能受到损害，出现少尿或无尿、电解质紊乱、酸碱平衡失调及血浆中肾排出的代谢产物（尿素、肌酐等）浓度增高。目前，新生儿AKI暂无有效的防治措施。近年来，随着血液净化技术进步，连续性血液净化（ continuous blood purification，CBP）应用范围已从儿童AKI已发展到新生儿AKI。由于新生儿血液动力学不稳定及血容量小等特点，CBP在新生儿AKI中应用仍然面临诸多问题。该文就新生儿AKI的高危因素、诊断标准、新生儿CBP治疗相关问题等进行综述。
신생인급성신손상（ acute kidney injury，AKI）시신생인위중증지일，재신생인중증감호병방중적발생솔고체23％，병사솔25％～50％。신생인AKI시지신생인재저혈용량、질식、휴극、결양、용혈、저체온등각충불리인소도치신공능수도손해，출현소뇨혹무뇨、전해질문란、산감평형실조급혈장중신배출적대사산물（뇨소、기항등）농도증고。목전，신생인AKI잠무유효적방치조시。근년래，수착혈액정화기술진보，련속성혈액정화（ continuous blood purification，CBP）응용범위이종인동AKI이발전도신생인AKI。유우신생인혈액동역학불은정급혈용량소등특점，CBP재신생인AKI중응용잉연면림제다문제。해문취신생인AKI적고위인소、진단표준、신생인CBP치료상관문제등진행종술。
Acute kidney injury ( AKI) in newborns is one of neonatal critical disease,the incidence of AKI is 23%and the mortality is 25%~50%in neonatal intensive care unit (NICU).AKI in newborns is ab-normal renal function due to many various unfavorable factors,such as neonatal asphyxia,low blood volume, shock,hypoxia,hemolysis,low temperature,the clinical manifestations are oliguria or anuria,electrolyte disturb-ance,acid-base imbalance, high concentrations of metabolites in plasma and renal excretion ( urea, creatinine etc.) .At present,there are no effective prevention measures.In recent years,with the progress of blood purifica-tion technology,continuous blood purification ( CBP) has been used from AKI in children to AKI in newborns. Because of the neonatal hemodynamic instability and blood characteristics of small capacity, the application of CBP in the neonatal AKI still faces many problems.The paper summarizes high risk factors and diagnostic crite-ria of AKI in newborns,related problems of neonatal CBP treatment.