与坏死性小肠结肠炎婴儿急性肾损伤相关的时间和风险因素。
Timing and risk factors associated with acute kidney injury in infants with necrotizing enterocolitis.
机构信息
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Cooper Medical School of Rowan University, Camden, NJ, USA.
出版信息
J Perinatol. 2024 Dec;44(12):1774-1779. doi: 10.1038/s41372-024-02003-4. Epub 2024 May 22.
OBJECTIVE
To evaluate the prevalence, onset, risk factors, and mortality associated with acute kidney injury (AKI) in infants with necrotizing enterocolitis (NEC).
DESIGN/METHODS: Retrospective study at 2 centers in infants with NEC, with/without AKI. AKI assessed by serum creatinine and urine output. Statistical tests used included t, Mann-Whitney U, Chi-square, and Fisher Exact tests.
RESULTS
Among 80 eligible infants with NEC, 56 (70%) had AKI. Median onset of NEC was day 15, with median AKI onset two days (IQR, -5.75 to 0) prior to NEC onset. Vasopressors were significantly more likely to be used in infants with NEC and AKI (p = 0.009). Increased mortality (p = 0.01) was noted in infants with NEC and AKI.
CONCLUSIONS
The onset of AKI mostly precedes NEC onset, with moderate to severe AKI more prevalent than the milder form in infants with NEC. These infants are significantly more likely to be hemodynamically unstable and have increased mortality.
目的
评估坏死性小肠结肠炎（NEC）患儿并发急性肾损伤（AKI）的患病率、发病时间、危险因素和死亡率。
方法/设计：在 2 家中心对患有 NEC 的婴儿进行回顾性研究，包括合并和不合并 AKI 的患儿。采用血清肌酐和尿量评估 AKI。统计检验包括 t 检验、Mann-Whitney U 检验、卡方检验和 Fisher 确切概率检验。
结果
在 80 名符合条件的 NEC 婴儿中，56 名（70%）患有 AKI。NEC 的中位发病时间为第 15 天，AKI 的中位发病时间比 NEC 早两天（IQR，-5.75 至 0）。患有 NEC 和 AKI 的婴儿更可能使用血管加压药（p=0.009）。患有 NEC 和 AKI 的婴儿死亡率显著增加（p=0.01）。
结论
AKI 的发病时间大多早于 NEC，在 NEC 患儿中，中重度 AKI 比轻度 AKI 更常见。这些婴儿更可能存在血流动力学不稳定，死亡率更高。
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