Infants with acute renal failure must be closely monitored for which metabolic disturbance?

• A. Hypercalcemia
• B. Metabolic Acidosis
• C. Metabolic Alkalosis
• D. Hyperkalemia

Answer: (B)

Acute renal failure impairs the kidneys’ ability to excrete hydrogen ions and regenerate bicarbonate, so acid builds up while bicarbonate is lost. This creates metabolic acidosis, a common and important disturbance to monitor in infants with AKI. In neonates, the acidemia can reduce perfusion and affect respiratory drive, so blood gas analysis and serum bicarbonate are essential to track, with treatment aimed at correcting the acid–base imbalance as the underlying kidney dysfunction is addressed. Hyperkalemia can occur as well, but the primary metabolic issue these infants typically develop is metabolic acidosis.