Garunkštienė Rasa, Vaitkevičienė Rimutė, Paulavičienė Ieva, Drazdienė Nijolė, Čerkauskienė Rimantė
Neonatology Centre, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
Clinics of Children Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Acta Med Litu. 2018;25(3):166-172. doi: 10.6001/actamedica.v25i3.3864.
Acute kidney injury is associated with mortality of very low birth weight infants and reduces their survival regardless of other factors. The kidneys in the extremely preterm infants are very immature and susceptible to environmental factors. Clinical conditions and medications are risk factors for acute kidney injury in these patients. Nephrolithiasis in preterm infants is an extremely rare phenomenon that usually manifests as a complication of nephrocalcinosis. This is a case report that describes several episodes of acute kidney injury in the first two months of age in an extremely low birth weight infant with kidney stones in the background. The main causes that led to acute kidney injury in this patient were persistent ductus arteriosus, sepsis and captopril. At one month of age, ultrasound detected calcinates in the right kidney. Within two weeks a large number of linear stones formed across the collecting duct system. Small calcinates still remained in the right kidney when the girl was half a year of the corrected age. The evaluation of a neonate who develops acute kidney injury requires a systematic approach. Early identification of the emerging risk factors and prevention of nephrolithiasis along with effective treatment can reduce the risk of developing acute kidney injury in very low birth weight infants.
急性肾损伤与极低出生体重儿的死亡率相关，且无论其他因素如何都会降低其存活率。极早产儿的肾脏非常不成熟，易受环境因素影响。临床状况和药物是这些患者发生急性肾损伤的危险因素。早产儿肾结石是一种极为罕见的现象，通常表现为肾钙质沉着症的并发症。这是一篇病例报告，描述了一名极低出生体重儿在出生后两个月内发生的几次急性肾损伤，其背景是患有肾结石。导致该患者急性肾损伤的主要原因是动脉导管未闭、败血症和卡托普利。患儿1月龄时，超声检查发现右肾有钙化灶。两周内，集合管系统形成了大量线性结石。当该女童矫正年龄为半年时，右肾仍有小钙化灶。对发生急性肾损伤的新生儿进行评估需要采用系统的方法。早期识别新出现的危险因素、预防肾结石以及进行有效治疗，可以降低极低出生体重儿发生急性肾损伤的风险。
