Medical School, University Hospital of Saarland, Homburg, Germany.
Department of Paediatric Cardiology, University Children's Hospital of Saarland, Homburg, Germany.
Acta Paediatr. 2019 Apr;108(4):645-653. doi: 10.1111/apa.14563. Epub 2018 Oct 1.
We assessed the risk factors for transient acute kidney injury in very low birth weight (VLBW) infants treated for patent ductus arteriosus (PDA) using the serum creatinine-based criteria in Kidney Disease: Improving Global Outcomes.
This retrospective study of infants requiring ibuprofen and, or, surgery for haemodynamic relevant PDAs was performed at the University Children's Hospital of Saarland, Homburg, Germany, from January 2009 to December 2015.
We studied 422 infants with a mean birth weight of 1059 ± 308.2 g. Acute kidney injuries developed in 150/295 infants (50.9%) with spontaneous PDA closure, in 46/82 (56.1%) who received intravenous ibuprofen treatment, in 18/24 (75.0%) who had surgery and in 15/21 infants (71.4%) who received both medical and surgical treatment. Acute kidney injuries were associated with birth weight and gestational age, Apgar scores at 10 minutes, the PDA size corrected for birth weight, a PDA with three affected circulatory territories, PDA surgery and gentamicin. Multiple logistic regression analysis showed particular associations between acute kidney injury and birth weight (p = 0.001), the 10-minute Apgar score (p = 0.02) and gentamicin (p = 0.043).
Birth weight, the 10-minute Apgar score and gentamicin were particularly associated with acute kidney injuries in our cohort.
我们使用肾脏病：改善全球预后组织（KDIGO）基于血清肌酐的标准评估了接受前列腺素 E1 治疗的极低出生体重（VLBW）婴儿发生短暂性急性肾损伤的危险因素。
本研究回顾性分析了 2009 年 1 月至 2015 年 12 月德国萨尔兰大学儿童医院收治的需要布洛芬和/或手术治疗的有血流动力学意义的动脉导管未闭（PDA）患儿，共纳入 422 例患儿。
本研究共纳入 422 例患儿，平均出生体重为 1059±308.2g。在自发性 PDA 闭合的 295 例患儿中，150 例（50.9%）发生急性肾损伤；接受静脉用布洛芬治疗的 82 例患儿中，46 例（56.1%）发生急性肾损伤；接受手术治疗的 24 例患儿中，18 例（75.0%）发生急性肾损伤；接受药物和手术治疗的 21 例患儿中，15 例（71.4%）发生急性肾损伤。急性肾损伤与出生体重和胎龄、出生后 10 分钟的 Apgar 评分、出生体重校正后的 PDA 大小、影响 3 个循环区域的 PDA、PDA 手术和庆大霉素有关。多因素逻辑回归分析显示，急性肾损伤与出生体重（p=0.001）、出生后 10 分钟的 Apgar 评分（p=0.02）和庆大霉素（p=0.043）之间存在特定的关联。
在本队列中，出生体重、出生后 10 分钟的 Apgar 评分和庆大霉素与急性肾损伤的发生特别相关。
