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The prognostic value of serum creatinine dynamics in neonates

crossref(2024)

Victor Babeș University of Medicine and Pharmacy Timișoara

Cited 0|Views12
Abstract
Abstract Background: Acute kidney injury (nAKI) is common in neonates with increased mortality and hospitalization. Less is known about the creatinine dynamics outside acute kidney injury and impact on survival in new-borns in the first week of life. Methods: We performed an observational, retrospective, single-centre study on new-borns admitted to “Louis Turcanu” Emergency County Hospital for Children between 2014 and 2022. The cohort consisted in 1106 neonates with serum creatinine values recorded in the first day of life and at least another measurement between days 2 and 7. We evaluated the outcomes of ascending serum creatinine trend on mortality, hospital stay and chronic kidney disease development. Results: 23.4% (259) babies had an ascending trend of serum creatinine andhad on day one higher urea levels, lower haemoglobin and thrombocytes, lower serum proteins and higher degrees of inflammation compared to the ones with a descending trend. A rising creatinine increased the risk of nAKI in the first seven days by 12.93 times and overall nAKI by 4.07 times. Ascending creatinine trend independently increased mortality in the entire cohort by 1.92 times and 4.65 times in the subgroup of patients without AKI. In the crude analysis, ascending creatinine trend increased the risk of chronic kidney disease by 8.74 times and in adjusted model, only nAKI was an independent risk factor (8.57 times). Conclusions: Rising creatinine in the first week of life independently increased nAKI development and mortality. Even patients with small serum creatinine rises that did not reached nAKI presented higher mortality.
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要点】:研究揭示了新生儿血清肌酐动态变化对急性肾损伤发展及存活率的影响,肌酐上升与新生儿死亡风险和慢性肾病风险增加相关。

方法】:采用观测性、回顾性、单中心研究方法分析新生儿血清肌酐值的动态变化。

实验】:对2014至2022年间“Louis Turcanu”儿童急救县立医院收治的1106名新生儿进行了研究,这些新生儿在出生首日及第2至7天之间至少有两次血清肌酐值记录。结果显示,23.4%的婴儿血清肌酐呈现上升趋势,且与较高的尿素水平、较低的血红蛋白和血小板、较低的血清蛋白以及炎症程度增加有关。肌酐上升增加了新生儿首七天内AKI的风险,并独立增加了整体队列的死亡率,以及对没有AKI的亚组死亡率影响更大。