Introduction:Acute kidney injury (AKI) is one of the most common diseases among the newborns hospitalized in the neonatal intensive care units (NICUs), which is usually resulted from predisposing factors including sepsis, hypovolemia, asphyxia, respiratory distress syndrome (RDS), and heart failure. The goal of this study was to assess main etiologies, relevant risk factors, and early outcome of neonatal AKI.Materials and Methods:In a cross- sectional study, 49 consecutive neonates hospitalized in NICU of Besat hospital with diagnosis of AKI from October 2009 to October 2011 were investigated through census sampling method. AKI was diagnosed based on urine output and serum creatinine levels.Results:The prevalence of AKI was 1.54% (49 out of 3166 newborns hospitalized in NICU) with the female: male was 7:1. Thirty-nine patients (79.5%) were full-term neonates. Oliguria was observed in 38 (77.5%) patients. Sepsis was the most common predisposing factor for AKI in 77.5% of patients (n = 38) accompanied with the highest mortality rate among other factors (30.5%). Other leading causes of AKI included hypovolemia secondary to dehydration, followed by hypoxia secondary to RDS, patent ductus arteriosus, posterior urethral valve, asphyxia, and renal venous thrombosis. A positive relationship was observed between neonates' age, sex, urine output, and also between serum creatinine levels with initiation of dialysis. The mortality rate among the newborns hospitalized with AKI was 36.7%. Eighteen (36.7%) newborns were treated with peritoneal dialysis (PD) of whom 10 patients (55.6%) died, 31 patients were managed conservatively of whom five neonate died (25.9%).Discussion:Prognosis of AKI in the oliguric neonates requiring PD is very poor. It is thus recommended to prevent AKI by predicting and rapid diagnosis of AKI in patients with potential risk factors and also by early and effective treatment of such factors in individuals with AKI.

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Primary hyperparathyroidism is an endocrine disorder recognized by hyperfunction of parathyroid gland, which can result in persistent bone absorption and brown tumor. Facial involvement of brown tumor is rare and usually involves the mandible. Giant cell tumor ( GCT) is an expansile osteolytic bone tumor which is very similar in clinical, radiological and histological features to brown tumor. Herein, we present a 35-year-old woman with an 11-month history of gradually swelling of the right maxilla and buccal spaces began during pregnancy two years ago. No other clinical or laboratory problems were detected. Postpartum CT scan demonstrated a lytic expansile multi-septated mass lesion containing enhancing areas, which initially described as GCT of the right maxillary sinus following surgery. Four months later, gradual progressive swelling of the bed of tumor was recurred and revised pathological slices were compatible with GCT. Regarding patient recent paresthesia, repeated laboratory tests were performed. Finally, according to laboratory results (elevation of serum calcium and parathyroid hormone), ultrasonographic findings and radioisotope scan (Sestamibi), probable parathyroid mass and brown tumor of maxilla was diagnosed. Pathology confirmed hyperplasia of right inferior parathyroid gland. Our case was thought-provoking due to its interesting clinical presentation and unusual presentation of brown tumor in parathyroid hyperplasia.

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