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一项关于新生儿重症监护病房(NICU)住院早产儿急性肾损伤的研究。

A study of acute kidney injury in hospitalized preterm neonates in NICU.

作者信息

Nagaraj N, Berwal P K, Srinivas A, Berwal A

机构信息

Sardar Patel Medical College, Bikaner, Rajasthan, India.

Navodaya Medical College, Karnataka, India.

出版信息

J Neonatal Perinatal Med. 2016;9(4):417-421. doi: 10.3233/NPM-161614.

Abstract

OBJECTIVES

This study was carried out to determine the incidence, clinical features, etiology and outcome of functional and intrinsic acute kidney injury (AKI) in preterm neonates.

METHODS

This is a prospective observational study on premature infants admitted to the neonatal intensive care unit (NICU) over an eight month period. All biochemical parameters of renal function tests were monitored and statically analyzed.

RESULTS

The study included 450 infants; of them 300 were inborn and 150 infants were outborn and transported to the NICU. Mean gestational age, weight, and age at the time of AKI diagnosis were 32.3 weeks, 1.66 kg and 3.23 days respectively. The male: female ratio was 1.84:1. Incidence of AKI was higher in low birth weight babies. Sluggishness and refusal for feed were most common symptoms. Birth asphyxia and septicemia were the most common early and late cause of AKI. Hyponatremia was the most common electrolyte disturbance. The incidences of AKI, functional renal failure, and intrinsic renal failure were 12%, 48.14%, and 51.85% respectively.

CONCLUSIONS

AKI is not uncommon in preterm infants. The early recognition and aggressive management of episodes of shock which often precede AKI could be life-saving.

摘要

目的

本研究旨在确定早产儿功能性和内在性急性肾损伤(AKI)的发病率、临床特征、病因及转归。

方法

这是一项对新生儿重症监护病房(NICU)收治的早产儿进行的为期8个月的前瞻性观察研究。对所有肾功能检查的生化指标进行监测并进行统计学分析。

结果

该研究纳入了450例婴儿;其中300例为足月儿,150例为早产儿并转运至NICU。AKI诊断时的平均胎龄、体重和年龄分别为32.3周、1.66千克和3.23天。男女比例为1.84:1。低体重儿AKI的发病率较高。嗜睡和拒食是最常见的症状。出生窒息和败血症分别是AKI最常见的早期和晚期病因。低钠血症是最常见的电解质紊乱。AKI、功能性肾衰竭和内在性肾衰竭的发病率分别为12%、48.14%和51.85%。

结论

AKI在早产儿中并不罕见。对AKI之前常出现的休克发作进行早期识别和积极处理可能挽救生命。

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