scholarly journals Biomarkers of Kidney Injury in Very-low-birth-weight Preterm Infants: Influence of Maternal and Neonatal Factors

In Vivo ◽  
2020 ◽  
Vol 34 (3) ◽  
pp. 1333-1339 ◽  
Author(s):  
IRENE CAPELLI ◽  
FRANCESCA VITALI ◽  
FULVIA ZAPPULO ◽  
SILVIA MARTINI ◽  
CHIARA DONADEI ◽  
...  
2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097744
Author(s):  
Ebru Turkoglu Unal ◽  
Esra Arun Ozer ◽  
Zelal Kahramaner ◽  
Aydin Erdemir ◽  
Hese Cosar ◽  
...  

Objective This study aimed to evaluate the significance of urinary kidney injury molecule-1 (uKIM-1) levels in predicting acute kidney injury (AKI) and mortality in very low birth weight (VLBW) preterm infants. Methods This prospective, observational cohort study was conducted on 39 VLBW preterm infants. Serum creatinine (SCr) and uKIM-1 levels were measured in the first 24 and 48 to 72 hours of life. The estimated glomerular filtration rate (eGFR) was calculated. Levels of uKIM-1 were measured with an enzyme-linked immunosorbent assay. Results Among 39 VLBW infants, 9 (23%) developed AKI. The mortality rate was 17.9% (n = 7 neonates). There was no significant difference in SCr levels, uKIM-1 levels, or the eGFR obtained in the first 24 hours in the AKI group compared with controls. However, significant differences were found in SCr and uKIM-1 levels, and the eGFR rate at 48 to 72 hours between the groups. Levels of uKIM-1 were significantly higher in non-survivors than in survivors in the first 24 and 48 to 72 hours of life. Conclusion The level of uKIM-1 can be used as a simple noninvasive diagnostic method for predicting AKI and mortality, especially within 48 to 72 hours of life. Clinical trial registration: We do not have a clinical trial registration ID. In Turkey, clinical trial registration is not required for non-drug, noninvasive, clinical studies.


2020 ◽  
Vol 10 (6) ◽  
pp. 19-25
Author(s):  
Anna N. Obukhova ◽  
Olga V. Khaletskaya ◽  
Elena V. Tush

The aim of the investigation was to assess the functional state of the kidneys of preterm infants of various gestational ages with signs of acute kidney injury. Materials and Methods. The study included 30 preterm infants born at 29 to 36 weeks gestation with signs of acute kidney injury. Patients were divided into two groups: group I included children with low body weight, born at 3236 weeks of gestation; group II with very low birth weight, born at 2931 weeks of gestation. In the study of kidney function, the main markers were analyzed serum creatinine, urea, diuresis level, glomerular filtration rate (GFR) at the third week of life, as well as at discharge from the hospital when reaching the postconceptual gestational age of 36.0 [35.0; 39.0] weeks. Severity was assessed in both groups of patients. Results. In both groups of children, a slight degree of severity was recorded, the risk stage (Risk) according to the pRIFLE classification criteria (2007). The evaluation of the biochemical blood test did not show a statistically significant difference in creatinine, urea, GFR, and the rate of diuresis between groups of children with low body weight and very low birth weight. In both groups of patients, creatinine and urea levels in the third week of life exceeded the age standards. By the time the postconceptual gestational age was reached at 36.0 [35.0; 39.0] weeks, there was a statistically significant decrease in the level of these indicators in patients of both groups. In addition, it was found that premature children are at risk for the formation of hyperoxaluria (53% in the structure of crystalluria). Conclusion. Timely diagnosis of acute kidney injury in premature newborns will allow adequate therapy to prevent the progression and further formation of terminal renal failure. It is important to determine the level of excretion of oxalates in the urine to prevent the development of urolithiasis.


Author(s):  
Luciana Volpiano Fernandes ◽  
Ana Lucia Goulart ◽  
Amélia Miyashiro Nunes dos Santos ◽  
Marina Carvalho de Moraes Barros ◽  
Camila Campos Guerra ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajia Jing ◽  
Yiheng Dai ◽  
Yanqi Li ◽  
Ping Zhou ◽  
Xiaodong Li ◽  
...  

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.


2017 ◽  
Vol 31 (8) ◽  
pp. 988-992
Author(s):  
Selim Sancak ◽  
Tugba Gursoy ◽  
Abdulhamit Tuten ◽  
Didem Arman ◽  
Guner Karatekin ◽  
...  

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 1-8
Author(s):  
Kevin M. Shannon ◽  
Julian F. Keith ◽  
William C. Mentzer ◽  
Richard A. Ehrenkranz ◽  
Mark S. Brown ◽  
...  

Design and methods. We hypothesized that treatment with recombinant human erythropoietin (r-HuEPO) would stimulate erythropoiesis and would thereby reduce the need for erythrocyte transfusions in preterm infants. We treated 157 preterm infants born at 26.9 ± 1.6 weeks of gestation who weighed 924 ± 183 g at birth with either subcutaneous r-HuEPO (100 U/kg/d, 5 days per week) or placebo for 6 weeks in a randomized, double-blind, controlled clinical trial. All patients received oral iron and were managed according to uniform conservative transfusion guidelines. Results. Treatment with r-HuEPO was associated with fewer erythrocyte transfusions (1.1 ± 1.5 per infant in the r-HuEPO group versus 1.6 ± 1.7 per infant in the placebo group; P = .046) and with a reduction in the volume of packed erythrocytes transfused (16.5 ± 23.0 mL versus 23.9 ± 25.7 mL per infant; P = .023). Overall, 43% of the infants in the r-HuEPO group and 31% of placebo-treated infants were transfusion-free during the study (P = .18). The volume of blood removed for laboratory tests and the need for respiratory support at the start of treatment had major effects on transfusion requirements independent of r-HuEPO. Reticulocyte counts were higher during treatment in the r-HuEPO group (P = .0001), and r-HuEPO-treated infants had higher hematocrit values at the end of the study (32% versus 27.3% in the placebo group; P = .0001). We found no differences in the incidence of major complications of prematurity between the treatment groups. Conclusion. We conclude that treatment with r-HuEPO at a weekly dose of 500 U/kg stimulates erythropoiesis, moderates the course of anemia, is associated with a reduction in erythrocyte transfusions, and appears safe in very low birth weight preterm infants who are receiving iron supplements. Conservative transfusion criteria, minimization of phlebotomy losses, and treatment with r-HuEPO are complementary strategies to reduce erythrocyte transfusions in these infants.


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