Risk factors associated with acute kidney injury in extremely low birth weight (ELBW) infants
Risk factors associated with acute kidney injury in extremely low birth weight (ELBW) infants
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DOI：
10.1007/s00467-011-1977-8
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发表时间：
2012-02-01
影响因子：
3
通讯作者：
Mhanna, Maroun J.
中科院分区：
文献类型：
--
作者：
Viswanathan, Sreekanth;Manyam, Bindu;Mhanna, Maroun J.
本研究的目的是确定极低出生体重儿（ELBW）急性肾损伤（阿基）的发生率、危险因素和结局。在一项病例对照研究中，回顾了2000年1月1日至2008年1月31日期间入住我们新生儿重症监护室（NICU）的所有ELBW婴儿的病历。在研究期间，所有ELBW婴儿中有12.5%（59/472）发生阿基。46名有医疗记录的婴儿与46名对照组相匹配。阿基婴儿及其对照组的平均胎龄和出生体重分别为24.7 +/- 1.8 vs. 24.9 +/- 1.9周（p = 0.61）和614 +/- 128 vs. 616 +/- 127 g（p = 0.93）。与对照组相比，阿基婴儿的平均气道压较高，平均动脉血压较低，头孢噻肟暴露量较高。与对照组相比，阿基婴儿的死亡率也增加[分别为33/46（70%）vs. 10/46（22%）; p < 0.0001]，少尿患者的死亡率高于非少尿患者[分别为31/38（81%）vs. 2/8（25%），p = 0.003]。根据我们的研究结果，我们得出结论，高平均气道压，低血压，并使用头孢噻肟与肾功能衰竭ELBW婴儿。ELBW婴儿的阿基也与死亡率增加相关，尤其是在存在少尿的情况下。
The aim of this study was to determine the incidence, risk factors, and outcome of acute kidney injury (AKI) in extremely low birth weight (ELBW) infants. In a case-control study, medical records of all ELBW infants who were admitted to our Neonatal Intensive Care Unit (NICU) between 1 January 2000 and 31 January 2008 were reviewed. During the study period, 12.5% (59/472) of all ELBW infants developed AKI. Forty-six infants with available medical records were matched to 46 controls. The mean gestational age and birth weight of infants with AKI and their controls were 24.7 +/- 1.8 vs. 24.9 +/- 1.9 weeks (p = 0.61) and 614 +/- 128 vs. 616 +/- 127 g (p = 0.93), respectively. Infants with AKI had a higher mean airway pressure, a lower mean arterial blood pressure, and higher exposure to cefotaxime than their controls. Infants with AKI also had an increased mortality in comparison to their controls [33/46 (70%) vs. 10/46 (22%), respectively; p < 0.0001), and oliguric patients had a higher mortality than nonoliguric patients [31/38 (81%) vs. 2/8 (25%), respectively, p = 0.003]. Based on our results, we conclude that a high mean airway pressure, low blood pressure, and the use of cefotaxime are associated with renal failure in ELBW infants. AKI in ELBW infants is also associated with an increased mortality, especially in the presence of oliguria.