Choker G, Gouyon J B
Service de Pédiatrie 2, Dijon, France.
Biol Neonate. 2004;86(3):212-6. doi: 10.1159/000079619. Epub 2004 Jul 7.
This study was designed to improve the definition of acute renal failure (ARF) in very preterm infants. Twenty-eight newborn infants with gestational age < or =32 weeks were prospectively studied in the first 5 days of life and made up a control group as they did not present risk factors for vasomotor renal insufficiency. Renal insufficiency was defined as an increase in daily serum creatinine concentration above the 99th interval limit obtained in this control group, i.e., 43 micromol/l on day 1 and/or 21 micromol/l on day 2 and/or 14 micromol/l/day on day 3 and/or 22 micromol/l/day on day 4. According to this definition, 20 very preterm infants with ARF were identified. As compared with the control group, the ARF group showed more prolonged oliguric episodes, lower diuresis, insufficient weight loss (in spite of a reduction in water intake) and also more episodes with natremia <130 mEq/l (35 vs. 0%; p <0.05) and/or kalemia >6 mEq/l (40 vs. 11%; p <0.05). Therefore, assessment of daily changes in serum creatinine concentration in very preterm infants allows the diagnosis of clinically significant reduction in glomerular filtration rate.
本研究旨在完善极早产儿急性肾衰竭（ARF）的定义。对28例胎龄≤32周的新生儿在出生后前5天进行前瞻性研究，这些新生儿未出现血管运动性肾功能不全的危险因素，构成对照组。肾功能不全定义为每日血清肌酐浓度升高超过该对照组第99百分位区间上限，即第1天43微摩尔/升和/或第2天21微摩尔/升和/或第3天14微摩尔/升/天和/或第4天22微摩尔/升/天。根据此定义，确定了20例患有ARF的极早产儿。与对照组相比，ARF组少尿期更长、尿量更低、体重减轻不足（尽管减少了水摄入），且血钠＜130毫当量/升（35%对0%；p＜0.05）和/或血钾＞6毫当量/升（40%对11%；p＜0.05）的情况更多。因此，评估极早产儿血清肌酐浓度的每日变化可诊断出具有临床意义的肾小球滤过率降低。
