{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:43:19Z","timestamp":1790437399234,"version":"4.1.0"},"reference-count":95,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>In neonates, estimation of the glomerular filtration rate is problematic, and assessment of renal impairment is challenging. Serum creatinine is a widely used marker, and urine output is an important vital parameter monitored in intensive care settings, particularly in unwell neonates. However, the rapid changes after birth with adaptation to the extrauterine environment is a unique situation in which absolute serum creatinine is not a reliable indicator of renal function. A rise in serum creatinine from the previous value during the neonatal period can be a result of worsening renal function in neonates but is dependent on many other factors. In addition, urine output can be difficult to measure in sick neonates during their intensive care stay. Despite a high prevalence of acute kidney injury (AKI) in preterm and\/or unwell infants, the current definitions are not straightforward and do not take postnatal adaptation processes into account. The management of AKI is challenging in very young and small patients because the assessment of fluid status as well as balancing nutritional needs with fluid restriction can be problematic. The Australian Neonatal Medicines Formulary provides advice on drug dosing in the face of reduced renal function in neonates. Predictors (or long-term outcome, or recovery) after AKI diagnosis are still poorly described. Therefore, the diagnosis of neonatal AKI needs to be documented and transferred to the paediatrician responsible for the follow-up of the child. This educational review aims to give a perspective on neonatal kidney function and AKI, the relation of fluid balance and creatinine, the management of neonatal AKI and the consequences for drug dosing and long-term outcomes.<\/jats:p>","DOI":"10.3390\/children12030339","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T12:22:52Z","timestamp":1741350172000},"page":"339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Neonatal Kidney Function, Injury and Drug Dosing: A Contemporary Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2917-1172","authenticated-orcid":false,"given":"Eveline","family":"Staub","sequence":"first","affiliation":[{"name":"Department of Neonatology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia"},{"name":"University of Sydney Northern Clinical School, Royal North Shore Hospital, St Leonards, NSW 2065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas","family":"Bolisetty","sequence":"additional","affiliation":[{"name":"Department of Newborn Care, Royal Hospital for Women, Randwick, NSW 2031, Australia"},{"name":"School of Women\u2019s and Children\u2019s Health, University of New South Wales, Kensington, NSW 2031, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9921-5105","authenticated-orcid":false,"given":"Karel","family":"Allegaert","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Hospital Pharmacy, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8846-1650","authenticated-orcid":false,"given":"Anke","family":"Raaijmakers","sequence":"additional","affiliation":[{"name":"School of Women\u2019s and Children\u2019s Health, University of New South Wales, Kensington, NSW 2031, Australia"},{"name":"Department of Paediatric Nephrology, Sydney Children\u2019s Hospital, Randwick, NSW 2031, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1007\/s00467-016-3320-x","article-title":"Assessment of kidney function in preterm infants: Lifelong implications","volume":"31","author":"Abitbol","year":"2016","journal-title":"Pediatr. 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