Acute kidney injury in preterm infants admitted to a neonatal intensive care unit
Acute kidney injury in preterm infants admitted to a neonatal intensive care unit
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DOI：
10.1007/s00467-014-2837-0
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发表时间：
2014-11-01
影响因子：
3
通讯作者：
Doronjski, Aleksandra
中科院分区：
文献类型：
--
作者：
Stojanovic, Vesna;Barisic, Nenad;Doronjski, Aleksandra
早产儿急性肾损伤（阿基）的发生和治疗结果的影响因素尚不清楚。阿基定义为血清肌酐水平与基础值相比升高0.3 mg/dl，大多数阿基新生儿（94.8%）体重< 1,500 g。Logistic回归分析显示，出生后第5分钟Apgar评分< 5分、出生后第1天血清乳酸水平> 5分、出生后第1天核心体温< 36 A（0）C、发生败血症、颅内出血、坏死性小肠结肠炎、动脉导管未闭以及使用万古霉素或多巴胺治疗是发生阿基的独立危险因素。在校正有和无阿基的新生儿组后，计算的阿基新生儿治疗阴性结局（死亡）的风险比为2.215（CI 1.27-3.86）。患有阿基的新生儿在出生后第3天和第4天的血清钠水平较高。阿基与早产儿的高死亡率相关。尽快识别出所有有发生阿基高风险的婴儿非常重要。
The factors that contribute to the development of acute kidney injury (AKI) and treatment outcome among prematurely born neonates are not clearly understood.This retrospective study included 150 prematurely born neonates. AKI was defined as an increase of serum creatinine levels a parts per thousand yen0.3 mg/dl compared to basal values.The majority of neonates with AKI (94.8 %) had a body weight < 1,500 g. Logistic regression analysis showed that the Apgar score in the 5th minute < 5, serum lactate levels > 5 on the first day of life, core body temperature < 36 A(0)C on the first day of life, occurrence of sepsis, intracranial hemorrhage, necrotizing enterocolitis, patent ductus arteriosus, as well as a treatment with vancomycin or dopamine were independent risk factors for the development of AKI. After the groups of neonates with and without AKI were adjusted, the calculated risk ratio for a negative outcome of treatment (death) was 2.215 (CI 1.27-3.86) for neonates with AKI. Neonates with AKI had higher serum sodium levels in the third and fourth days of life.AKI is associated with high mortality in preterm neonates. It is very important to identify, as quickly as possible, all infants who are at high risk of developing AKI.