极低出生体重儿的急性肾损伤：一个主要的发病和死亡风险因素。
Acute Kidney Injury in Very Low Birth Weight Infants: A Major Morbidity and Mortality Risk Factor.
作者信息
Lazarovits Gilad, Ofek Shlomai Noa, Kheir Raed, Bdolah Abram Tali, Eventov Friedman Smadar, Volovelsky Oded
机构信息
Department of Neonatology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel.
School of Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel.
出版信息
Children (Basel). 2023 Jan 29;10(2):242. doi: 10.3390/children10020242.
BACKGROUND AND OBJECTIVES
Very low birth weight (VLBW) infants are at high risk of developing acute kidney injury (AKI), presumably secondary to low kidney reserves, stressful postnatal events, and drug exposures. Our study aimed to identify the prevalence, risk factors, and outcomes associated with AKI in VLBW infants.
STUDY DESIGN
Records of all VLBW infants admitted to two medical campuses between January 2019 and June 2020 were retrospectively reviewed. AKI was classified using the modified KDIGO definition to include only serum creatinine. Risk factors and composite outcomes were compared between infants with and without AKI. We evaluated the main predictors of AKI and death with forward stepwise regression analysis.
RESULTS
152 VLBW infants were enrolled. 21% of them developed AKI. Based on the multivariable analysis, the most significant predictors of AKI were the use of vasopressors, patent ductus arteriosus, and bloodstream infection. AKI had a strong and independent association with neonatal mortality.
CONCLUSIONS
AKI is common in VLBW infants and is a significant risk factor for mortality. Efforts to prevent AKI are necessary to prevent its harmful effects.
背景与目的
极低出生体重（VLBW）婴儿发生急性肾损伤（AKI）的风险很高，可能继发于肾脏储备低、产后应激事件和药物暴露。我们的研究旨在确定VLBW婴儿中AKI的患病率、危险因素及相关结局。
研究设计
回顾性分析2019年1月至2020年6月期间入住两个医学园区的所有VLBW婴儿的记录。AKI采用改良的KDIGO定义进行分类，仅包括血清肌酐。比较发生AKI和未发生AKI的婴儿的危险因素及复合结局。我们采用向前逐步回归分析评估AKI和死亡的主要预测因素。
结果
共纳入152例VLBW婴儿。其中21%发生了AKI。基于多变量分析，AKI最显著的预测因素是使用血管加压药、动脉导管未闭和血流感染。AKI与新生儿死亡率有强烈且独立的关联。
结论
AKI在VLBW婴儿中很常见，是死亡率的一个重要危险因素。为预防AKI的有害影响，有必要努力预防AKI。
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