Postnatal creatinemia in extremely low birth weight (ELBW) neonates reflects perinatal renal maturational physiology

摘要

To assess perinatal renal physiology is extreme low birth weight (ELBW, <1000g) neonates, prenatal covariates [betamethasone, preterm rupture of membranes (PPROM), pre-eclampsia, maternal Scr], at delivery [gestational age (GA), birth weight (BW), small for GA (SGA), Apgar, intubation] and during neonatal stay [ventilation, oxygen, parenteral nutrition, ibuprofen, steroids, intraventricular haemorrhage, retinopathy of prematurity (ROP)] were linked with Scr (mg/dl) (day 1-9, 14, 21, 28, 42, peak Scr). Based on observations in 151 ELBW neonates [GA 27(23-33) weeks, BW 810(370-1000) g, SGA 34%], an initial increase in Scr was observed resulting in a peak Scr on day 3 or 4 (1.13,0.53-2.51) with subsequent decrease. Multiple and logistic regression confirmed that GA and ventilation or Apgar were independent risks factors for renal impairment. ELBW neonates display similar Scr trends compared to heavier neonates, but peak Scr is higher, its subsequent decrease slower. Renal impairment in ELBW neonates reflects immaturity and morbidity.