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新生儿急性肾损伤的神经学表现:聚焦临床放射学特征

Neurological Manifestation of Neonatal Acute Kidney Injury: Focusing on the Clinico-Radiological Profile.

作者信息

Gupta Purnima, Meena Ankit Kumar, Parakh Esha, Wander Arvinder, Rathore Bhanupratap, Jangid Hemant, Parakh Manish

机构信息

Department of Pediatrics, Dr. Sampurnanand Medical College, Jodhpur, IND.

Department of Pediatrics, All India Institute of Medical Sciences, Bathinda, IND.

出版信息

Cureus. 2024 Sep 12;16(9):e69253. doi: 10.7759/cureus.69253. eCollection 2024 Sep.

Abstract

Purpose This study aimed at studying the neurological manifestation of neonatal acute kidney injury, focusing on the clinico-radiological profile. Methodology In this cross-sectional study, newborns hospitalized in the neonatal intensive care unit of a tertiary care hospital were enrolled over a study period of one year. As per the Kidney Disease: Improving Global Outcome (KDIGO) criteria, 74 neonates were enrolled, and magnetic resonance imaging (MRI) was performed on the same neonates. Result In this study, acute kidney injury (AKI) was seen more often in neonates with admission weights between 1,500 and 2,499 grams, accounting for 52.7% of total study participants. In the current study, neonates admitted with AKI presented more with signs and symptoms of encephalopathy, such as lethargy (78.4%), seizures (64.8%), and irritability (35.1%) at admission. Signs and symptoms of fever and decreased urine output were more common after the first week of life. Abnormal MRI findings were observed in 64.9% of neonates with AKI. The mean blood urea and serum creatinine levels in neonates with abnormal MRI were 188.14 ± 108.25 mg/dL and 2.93 ± 2.16 mg/dL, respectively. The mean blood urea and serum creatinine levels in neonates with normal MRI were 169.84 ± 65.45 mg/dL and 2.41 ± 1.85 mg/dL, respectively. Of the 74 neonates enrolled with AKI, 12 (16.21%) had CSVT. These neonates had a mean blood urea level of 231.58 ± 111.66 mg/dL (p = 0.047) and a mean creatinine level of 3.77 ± 2.78 mg/dL. Conclusion Neonatal AKI has a variable presentation with high mortality and morbidity. Elevated serum urea and creatinine can be used to predict CSVT.

摘要

目的 本研究旨在探讨新生儿急性肾损伤的神经学表现,重点关注临床放射学特征。方法 在这项横断面研究中,选取一家三级医院新生儿重症监护病房住院的新生儿,研究期为一年。根据改善全球肾脏病预后组织(KDIGO)标准,纳入74例新生儿,并对这些新生儿进行磁共振成像(MRI)检查。结果 在本研究中,入院体重在1500至2499克之间的新生儿急性肾损伤(AKI)更为常见,占总研究对象的52.7%。在本研究中,因AKI入院的新生儿入院时更多表现为脑病的体征和症状,如嗜睡(78.4%)、惊厥(64.8%)和易激惹(35.1%)。发热和尿量减少的体征和症状在出生后第一周后更为常见。64.9%的AKI新生儿MRI检查结果异常。MRI检查结果异常的新生儿平均血尿素和血清肌酐水平分别为188.14±108.25mg/dL和2.93±2.16mg/dL。MRI检查结果正常的新生儿平均血尿素和血清肌酐水平分别为169.84±65.45mg/dL和2.41±1.85mg/dL。在纳入的74例AKI新生儿中,12例(16.21%)发生了脑静脉窦血栓形成(CSVT)。这些新生儿的平均血尿素水平为231.58±111.66mg/dL(p = 0.047),平均肌酐水平为3.77±2.78mg/dL。结论 新生儿AKI表现多样,死亡率和发病率高。血清尿素和肌酐升高可用于预测CSVT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3712/11470434/dfa7a1a27ebd/cureus-0016-00000069253-i01.jpg

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