Nephrocalcinosis in preterm neonates

Schell-Feith, Eveline A.; Holthe, Joana E. Kist-van; Heijden, Albert J. van der

doi:10.1007/s00467-008-0908-9

Cited by 85 publications

(69 citation statements)

References 76 publications

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“…Also, during the neonatal period, VLBW infants are exposed more frequently and for a longer time to multiple risk factors associated with treatment. 28 In this study the NC group had lower gestational age and birth weight than the control group. The NC group also had lower 5 minute Apgar score, initial blood pH, the lowest systolic blood pressure and urine output on the first day of life than the control group.…”

Section: Discussionmentioning

confidence: 85%

Risk Factors and Outcome of Nephrocalcinosis in Very Low Birth Weight Infants

et al. 2015

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� Original Article � furosemide therapy in 1982. Among different studies, the prevalence of NC ranged from 7 to 41% in very low birth weight (VLBW) infants with a gestational age less than 32 weeks. [3][4][5][6][7][8][9] The etiology of NC is multifactorial including low gestational age and birth weight. Male sex, family history, white race, mechanical ventilation, oxygen therapy, bronchopulmonary dysplasia (BPD), the use of furosemide, methylxanthine, dexamethasone, gentamicin, total parenteral nutrition (TPN), acidosis, hypercalcemia, hypophosphatemia, hypercalciuria, hyperoxaluria, hyperuricuria, and hypocitruria are associated with development of NC. Purpose: The aim of this study was to determine the incidence, risk factors, and long-term outcome of nephrocalcinosis in very low birth weight (VLBW) infants. Methods: A retrospective chart review was performed in VLBW infants between 2006 and 2012 in the neonatal intensive care unit. Results:The incidence of nephrocalcinosis in VLBW infants was 10.2%. By univariate analysis, oligohydramnios and use of antenatal steroids were more frequent in the nephrocalcinosis group. In the nephrocalcinosis group, the gestational age and birth weight were lower and there were more number of female infants. Also, the initial blood pH, the lowest systolic blood pressure, and urine output on the first day of life were lower and bronchopulmonary dysplasia, sepsis, and urinary tract infection were more prevalent in the nephrocalcinosis group. The use of dexamethasone or ibuprofen and the lowest levels of phosphorus, protein and albumin were significantly lower in the nephrocalcinosis group. By binary logistic regression analysis, the use of antenatal steroids, female sex, 5-minute Apgar score, duration of oxygen therapy and total parenteral nutrition, and the lowest albumin level were found to be significant risk factors for nephrocalcinosis. Overall, the resolution rate was 64.1% and 88.6% within 12 months and 18 months, respectively. Conclusions:The incidence of nephrocalcinosis in VLBW infants showed increasing trend. The risk factors of nephrocalcinosis were parameters for sick VLBW infants. Although the prognosis of nephrocalcinosis was relatively good, we should pay close attention to the development of complication.

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Section: Discussionmentioning

confidence: 85%

Risk Factors and Outcome of Nephrocalcinosis in Very Low Birth Weight Infants

et al. 2015

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“…As a result, conditions are favorable for the formation of crystals, which can stick to the surface and grow and aggregate in the tubules [9]. Moreover, an association between dexamethasone treatment, high calcium excretion and NC is found in preterm neonates [9,10]. Our patient received two courses of dexamethasone to prevent extubation failure.…”

Section: Discussionmentioning

confidence: 88%

“…Nephrocalcinosis (NC) in preterm neonates occurs as a result of imbalance between stonepromoting and stone-inhibiting factors [9]. There is a clear correlation between prevalence of NC and low gestational age [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…There is a clear correlation between prevalence of NC and low gestational age [9,10]. Premature kidneys have relatively well-developed deep nephrons, with a long loop of Henle and probably low urine velocity.…”

Section: Discussionmentioning

confidence: 99%

“…Premature kidneys have relatively well-developed deep nephrons, with a long loop of Henle and probably low urine velocity. As a result, conditions are favorable for the formation of crystals, which can stick to the surface and grow and aggregate in the tubules [9]. Moreover, an association between dexamethasone treatment, high calcium excretion and NC is found in preterm neonates [9,10].…”

Section: Discussionmentioning

confidence: 99%

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Coexistence of Central and Nephrogenic Diabetes Insipidus in a Preterm Infant

Carolina¹,

Cordero-González²

2017

JCR

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Background: Diabetes insipidus (DI) is a rare cause of hypernatremia in preterm newborns. Common causes of central DI include intra-ventricular hemorrhage, congenital infection and midline defects. Nephrogenic DI (NDI) is less frequent and can be caused by nephrocalcinosis. Case Report: We hereby report 665 gram female infant born at 27 weeks gestation with central DI and treated with desmopressin. The infant presented again with hypernatremia and showed a poor response to desmopressin. The finding of nephrocalcinosis oriented us to a nephrogenic component of DI. Conclusion: Although nephrogenic diabetes insipidus is the less frequent form of DI, preterm newborns present many risk factors for developing nephrocalcinosis (prolonged ventilation, diuretic therapy, dexamethasone, hypercalcemia) and NDI as a result. In a preterm newborn with CDI, a nephrogenic component must be suspected in the set of decreasing response to DDAVP.

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