Kari Jameela A, Sharief Sara N, El Desoky Sherif M, Alhasan Khalid A, Albanna Amr S
Pediatric Nephrology Center of Excellence, Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
Saudi Med J. 2018 Apr;39(4):361-367. doi: 10.15537/smj.2018.4.21712.
To report the epidemiology of chronic kidney disease (CKD) in neonates at a single tertiary center and the outcomes of renal replacement therapy (RRT) in these patients and discuss ethical considerations regarding RRT in this population.
In this retrospective study, we reviewed clinical data from all neonates with evidence of CKD who were followed up at King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between 2005 and 2015. Follow-up serum creatinine levels were recorded every 6 months. Results: A total of 181 neonates presented with CKD. Their mean age at the time of presentation was 11.1 days (95% confidence interval [CI]: 9.5-12.8) and the mean creatinine level was 106.5 µmol/ (95% CI: 91.3-121.7). Congenital anomalies of the kidneys and urinary tract (CAKUT) were the underlying causes of CKD in 84.5% of the neonates. Mortality was high, particularly in the first 6 months (10%), and reached 16% by 4 years of follow-up. At the time of the last follow-up, 42 (41%) neonates had hypertension and 27 (26.5%) had significant proteinuria. Five patients received dialysis in the neonatal period and another 6 were commenced on dialysis later.
Congenital anomalies of the kidneys and urinary tract is the most common etiology in neonates with CKD. Chronic kidney disease in neonates is associated with high morbidity and mortality rates.
报告一家三级医疗中心新生儿慢性肾脏病（CKD）的流行病学情况以及这些患者的肾脏替代治疗（RRT）结局，并讨论该人群中RRT的伦理考量。
在这项回顾性研究中，我们回顾了2005年至2015年间在沙特阿拉伯王国吉达阿卜杜勒阿齐兹国王大学接受随访的所有有CKD证据的新生儿的临床数据。每6个月记录一次随访时的血清肌酐水平。
共有181例新生儿出现CKD。他们就诊时的平均年龄为11.1天（95%置信区间[CI]：9.5 - 12.8），平均肌酐水平为106.5µmol/（95%CI：91.3 - 121.7）。84.5%的新生儿CKD的潜在病因是肾脏和尿路先天性异常（CAKUT）。死亡率很高，尤其是在最初6个月（10%），到随访4年时达到16%。在最后一次随访时，42例（41%）新生儿患有高血压，27例（26.5%）有大量蛋白尿。5例患者在新生儿期接受了透析，另外6例后来开始透析。
肾脏和尿路先天性异常是新生儿CKD最常见的病因。新生儿慢性肾脏病与高发病率和死亡率相关。
