Elmas Ahmet Taner, Tabel Yılmaz, Özdemir Ramazan
Department of Pediatric Nephrology, Faculty of Medicine, University of İnönü, Malatya, Turkey.
Departments of Neonatology, Faculty of Medicine, University of İnönü, Malatya, Turkey.
J Clin Lab Anal. 2018 Sep;32(7):e22441. doi: 10.1002/jcla.22441. Epub 2018 Mar 31.
Acute kidney injury (AKI) is a common morbidity in neonatal intensive care units and associated with poor outcome. This study aimed to determine the prevalence of AKI and provide a demographic data and risk factors associated with the mortality and morbidity.
This is a retrospective study included 105 premature babies. Diagnosis of AKI was based on neonatal KDIGO classification criteria. The babies were stratified into two groups according to AKI status during the hospitalization. Clinical and laboratory characteristics of the AKI group were compared to non-AKI group.
AKI occurred in 21 (20.0%) of 105 premature babies, and mortality rate in these babies was 61.9%. Lower gestational weeks, lower Apgar scores at 5 minutes, lower systolic blood pressures, and inotropic supports were independent risk factors for the development of AKI in preterm babies (P < .05, for each). Oliguria, preeclampsia/eclampsia, resuscitation at birth, lower diastolic blood pressure, patent ductus arteriosus (PDA), inotropic support, and furosemide treatment were associated with the mortality (P < .05, for each).
Prenatal risk factors and medical interventions are associated with AKI, and AKI is associated with increased morbidity and mortality. Therefore, identification of AKI is very important in this vulnerable population and it should be performed as quickly as possible in all babies who are at high risk for developing of AKI.
急性肾损伤(AKI)是新生儿重症监护病房的常见病症,且与不良预后相关。本研究旨在确定AKI的患病率,并提供与死亡率和发病率相关的人口统计学数据及风险因素。
这是一项回顾性研究,纳入了105名早产儿。AKI的诊断基于新生儿KDIGO分类标准。根据住院期间的AKI状态将婴儿分为两组。将AKI组的临床和实验室特征与非AKI组进行比较。
105名早产儿中有21名(20.0%)发生了AKI,这些婴儿的死亡率为61.9%。孕周较低、5分钟时阿氏评分较低、收缩压较低以及使用血管活性药物支持是早产儿发生AKI的独立危险因素(每项P < 0.05)。少尿、子痫前期/子痫、出生时复苏、舒张压较低、动脉导管未闭(PDA)、使用血管活性药物支持以及呋塞米治疗与死亡率相关(每项P < 0.05)。
产前危险因素和医疗干预与AKI相关,且AKI与发病率和死亡率增加相关。因此,在这一脆弱人群中识别AKI非常重要,对于所有有发生AKI高风险的婴儿应尽快进行识别。