Prognostic Factors in Neonatal Acute Renal Failure

Chevalier, Robert L.; Campbell, F.; Brenbridge, AN

doi:10.1016/s0022-5347(17)48855-0

Cited by 33 publications

(48 citation statements)

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“…Acute renal failure in the aggressive group is similar to that described in the literature. 13 The rate of hyperglycemia in the aggressive group was lower than that of other reported series. 14 This might be related to the stimulating effect on the insulin secretion that the early introduction of amino acids produces.…”

Section: Discussioncontrasting

confidence: 55%

Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Dinerstein¹,

Nieto²,

Solana³

et al. 2006

J Perinatol

152

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Objective: To compare postnatal growth and nutritional deficits after the implementation of two different nutritional strategies in two consecutives periods of time.Methods: An early and aggressive nutritional regimen was used in a cohort of 117 very low birth weight (VLBW) infants. Amino acids were administered at the rate of 1.5 g/kg/day along with 5.6 mg/k/min of glucose flow on day 1 of life, and progressively increased to 4 g/kg/day and 13 mg/kg/min. Intravenous lipids were started at 0.5 g/kg/day at 24 h from birth, and increased to 3.5 g/kg/day; enteral feeding was begun at day 1 of life. Uni-and multivariate analyses were used to compare this group with the conventional group of 65 VLBW infants conservatively fed.Results: Univariate analysis showed that in the aggressive group there was a 66% reduction in the risk of post natal malnutrition at 40 weeks of postmenstrual age (OR 0.34; 95% CI 0.17-0.67). This difference persisted in the multivariate analysis. Energy and protein deficits were lower in the aggressive group (P<0.001).Conclusions: Early and aggressive introduction of total parenteral nutrition and enteral feeding resulted in better growth in weight, length and head circumference, and a reduction of nutritional deficits at 40 weeks of postmenstrual age.

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Section: Discussioncontrasting

confidence: 55%

Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Dinerstein¹,

Nieto²,

Solana³

et al. 2006

J Perinatol

152

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“…The mortality rate in infants with ARF cited in several reports is between 45 and 86% [1,2,[7][8][9]. Although our mortality of 77% is high, it is comparable to the 90% reported recently by Meeks and Sims [3], whose population of patients was similar to ours.…”

Section: Discussionsupporting

confidence: 85%

Acute Renal Failure in Neonates: A Prospective Study

et al. 1991

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Babies admitted to a neonatal intensive care unit in whom acute renal failure developed were studied prospectively to determine the etiology, course, and outcome of the disorder, as well as the reliability of renal indices in distinguishing intrinsic from prerenal renal failure. The incidence of neonatal acute renal failure was 3.6% (22/603). The most frequent causes were hypotension (86%), respiratory distress syndrome (41%), sepsis (32%), and asphyxia (27%). Half of the patients were born at less than 32 weeks' gestation and had a birth weight of less than 1500 gm. There was intrinsic renal failure in 15 neonates and prerenal failure in seven. Renal indices (urine-to-plasma ratio of osmolality, fractional excretion of sodium, and renal failure index) were not reliable in differentiating between intrinsic or prerenal failure. Mortality from renal failure was high at 77%. Survivors of neonatal acute renal failure who had no underlying congenital anomalies of the urinary tract did not appear to exhibit residual renal impairment during follow-up evaluation. It is important to identify those clinical indices that can be used in determining the diagnosis and prognosis of acute renal failure in neonates, particularly in very premature, low-birth-weight babies.

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“…In the present study, mortality rate of 29.4% was noted in neonates with renal involvement which was comparable with most other studies. [16][17][18] Multiorgan dysfunction was seen in 80.8% of cases. With increase in number of organ dysfunction there was resultant poor outcome.…”

Section: Discussionmentioning

confidence: 99%

Incidence of multiorgan dysfunction in perinatal asphyxia

Pattar

Raj

Yelamali

2015

Int J Contemp Pediatr

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INTRODUCTIONBirth asphyxia refers to condition of hypoxemia, hypercapnia and insufficient blood perfusion of new born during labour and birth. NNPD defines moderate birth asphyxia as APGAR score of 4-6 at 1minute and severe birth asphyxia as APGAR score of <3 at 1 minute.1 AAP defines it as APGAR score of less than 3 at 5minutes associated with cord pH of less than 7.0, presence of neurologic dysfunction and evidence of multiorgan dysfunction. 2Perinatal Asphyxia (PA) is a major public health problem. As per the latest estimates, PA accounts for 9% (i.e. 0·8 million) of total under-5 mortality (i.e. 8.8 millions) worldwide, being one of the three most common causes of neonatal deaths along with prematurity and bacterial infections. Of a total of 2.7 million stillbirths globally, approximately 1.2 million occur during intrapartum period, largely owing to asphyxia.3 As per NNPD, 9.5% of babies require some form of resuscitation. Manifestations of Hypoxic Ischaemic Encephalopathy (HIE) were seen in approximately 1.4% of all babies. PA was responsible for 28.8% of all neonatal deaths. Apart from neonatal deaths, asphyxia is responsible for life-long neuromotor disability in a large number of children. 1 ABSTRACTBackground: Objectives of current study was to study the incidence of multiorgan dysfunction in babies with perinatal asphyxia and its effect on the outcome. Methods: All term babies admitted to NICU of S. Nijalingappa Medical College and Hanagal Shri Kumareshwara Hospital, Bagalkot in the period January 2013 to December 2013 with perinatal asphyxia and HIE were included in the study. Detailed history and thorough examination was done using predesigned and prestructured proforma. Necessary investigations were done as indicated to identify organ dysfunction. Results: 80.8% of babies with perinatal asphyxia had evidence of multiorgan dysfunction with HIE alone seen in 19.2% of cases. Respiratory failure was the most common organ dysfunction after CNS seen in 63.1% of cases. CVS involvement was seen in 54.3% (31) of babies, out of which the mortality was seen in 22.5% (7 cases), renal involvement was seen in 29.8% (17) of babies, out of which the mortality was seen in 29.4% (5 cases). Increased mortality in babies who had cardiovascular dysfunction and in babies with renal dysfunction was statistically significant. Mortality was higher in babies with multiorgan dysfunction which increased proportionately with increase in number of organs involved. Conclusions: Multiorgan dysfunction is common in babies with perinatal asphyxia. Cardiovascular involvement and renal involvement are associated with poor outcome. Mortality is directly proportional to the number of organs involved.

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Prognostic Factors in Neonatal Acute Renal Failure

Cited by 33 publications

References 0 publications

Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Early and aggressive nutritional strategy (parenteral and enteral) decreases postnatal growth failure in very low birth weight infants

Acute Renal Failure in Neonates: A Prospective Study

Incidence of multiorgan dysfunction in perinatal asphyxia

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