Acute kidney injury in preterm infants admitted to a neonatal intensive care unit.

ABSTRACT

BACKGROUND: The factors that contribute to the development of acute kidney injury (AKI) and treatment outcome among prematurely born neonates are not clearly understood. METHODS: This retrospective study included 150 prematurely born neonates. AKI was defined as an increase of serum creatinine levels ≥0.3 mg/dl compared to basal values. RESULTS: The majority of neonates with AKI (94.8 %) had a body weight <1,500 g. Logistic regression analysis showed that the Apgar score in the 5th minute <5, serum lactate levels >5 on the first day of life, core body temperature <36 ºC on the first day of life, occurrence of sepsis, intracranial hemorrhage, necrotizing enterocolitis, patent ductus arteriosus, as well as a treatment with vancomycin or dopamine were independent risk factors for the development of AKI. After the groups of neonates with and without AKI were adjusted, the calculated risk ratio for a negative outcome of treatment (death) was 2.215 (CI 1.27-3.86) for neonates with AKI. Neonates with AKI had higher serum sodium levels in the third and fourth days of life. CONCLUSIONS: AKI is associated with high mortality in preterm neonates. It is very important to identify, as quickly as possible, all infants who are at high risk of developing AKI.