nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2019-23-5-9-16nefr-1738Research ArticleПЕРЕДОВАЯ СТАТЬЯLEADING ARTICLEОстрое повреждение почек у новорожденных детей: классификация, этиология и эпидемиологияAcute kidney injury in the newborn infant: classification, causes and epidemiologyИвановД. О.IvanovD. I.

Иванов Дмитрий Олегович - профессор, доктор мед. наук, ректор ФГБОУ ВО СПбГПМУ, заведующий кафедрой неонатологии с курсами неврологии и акушерства-гинекологии; главный неонатолог МЗ РФ

194100, Санкт-Петербург, Литовская, д. 2. Тел.: (812) 5423983

Dmitry O. Ivanov - MD, PhD, Dr Med Sci, Rector of the St-Petersburg State Pediatric Medical University Ministry of Healthcare of the Russian Federation, Head of the Department of Neonatology with courses of neurology and obstetrics-gynecology; Chef Neonatologist, Ministry of Healthcare of the Russian Federatuon

194100, St-Petersburg, Litovskaya st., 2. The Phone: (812) 5423983

doivanov@yandex.ruhttps://orcid.org/0000-0002-9415-4785СавенковаН. Д.SavenkovaN. D.

Савенкова Надежда Дмитриевна - профессор, доктор мед. наук, заведующая кафедрой факультетской педиатрии

194100, Санкт-Петербург, ул. Литовская, д. 2. Тел.: (812)4165266

Nadezhda D. Savenkova - MD, PhD, D Med Sci, Head of the Department of faculty pediatrics

194100, St-Petersburg, Litovskaya st., 2. The Phone: (812)4165286

Savenkova.n.spb@mail.ruСанкт-Петербургский государственный педиатрический медицинский университетРоссияSaint-Petersburg State Pediatric Medical UniversityRussian Federation201906082019235916Copyright © Иванов Д.О., Савенкова Н.Д., 20192019Иванов Д.О., Савенкова Н.Д.Ivanov D.I., Savenkova N.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1738

В статье представлены классификации, причины и эпидемиология острого повреждения почек (ОПП) у новорожденных, освещены нерешенные проблемы. Обсуждены классификации неонатального ОПП, предложенные Acute Kidney Injury Network (2007), J.G. Jetton, D.J. Askenazi (2012), модификации от NKC, KDIGO и AWAKEN (2016), AKI Workshop (2017). Обсуждены результаты международного исследования Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN), J.G. Jetton et al. (2016, 2017). Из 2022 новорожденных 605 (30 %) имели статус ОПП, из них в 48 % у 273 недоношенных, родившихся на 22–29-й неделях гестационного возраста; в 18 % у 916 недоношенных, родившихся на 29–36-й неделях; в 37 % у 833 новорожденных, родившихся после 36 нед. К факторами риска развития раннего ОПП у недоношенных новорожденных относят низкий гестационный возраст и экстремально низкую массу тела. По данным международных эпидемиологических исследований, развитие ОПП у недоношенных новорожденных является основным и независимым фактором риска смертности, формирования хронической болезни почек. Отсутствие многоцентровых эпидемиологических исследований ОПП у новорожденных в нашей стране является еще нерешенной проблемой. Решение стоящей перед отечественной неонатологией проблемы должно быть направлено на обеспечение единого подхода к классификациям ОПП, на изучение эпидемиологии, особенностей развития, течения и исхода ОПП различной этиологии, на разработку алгоритмов профилактики, диагностики и его лечения у доношенных и недоношенных новорожденных.

In the article are presented classifications, causes and epidemiology of acute kidney injury (AKI) in newborns, unsolved problems. Neonatal AKI classifications proposed by Acute Kidney Injury Network (2007), JG Jetton, DJ Askenazi (2012), modifications from NKC, KDIGO, and AWAKEN (2016), AKI Workshop (2017) are discussed. The results of the international assessment Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN), JG Jetton et al (2016, 2017) are discussed. Of the 2022 babies, 605 (30 %) had the status of AKI: in 48 % of the 273 preterm neonates with gestatoinal age 22-29 weeks; 18 % of 916 preterm neonates with gestatoinal age 29-36 weeks; in 37 % of 833 neonates with gestatoinal age after 36 weeks. The risk factors for the development of early AKI in preterm infants include low gestational age and very low birth weight. According to international epidemiological studies, the development of AKI in premature newborns is the main and independent risk factor for mortality and the formation of chronic kidney disease. The absence of multicenter epidemiological studies of acute kidney damage in newborns in our country is still an unsolved problem. The solution of the problem facing the national neonatology should be aimed at ensuring a unified approach to the classifications of acute kidney damage, on studying epidemiology, features of development, course, and outcome of acute kidney damage of various etiologies, on developing algorithms for prevention, diagnosis and treatment in term and preterm infants.

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The authors declare that there are no conflicts of interest present.