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Nephrocalcinosis in preterm babies.

A Narendra1, M P White, H A Rolton

  • 1Department of Neonatology, The Qeen Mother's Hospital, Glasgow G3 8SJ, UK. N.Aladangady@qmw.ac.uk

Archives of Disease in Childhood. Fetal and Neonatal Edition
|October 23, 2001
PubMed
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Sixteen percent of preterm infants developed nephrocalcinosis, a kidney condition. Risk factors include extreme prematurity, severe respiratory issues, male sex, and gentamicin use.

Area of Science:

  • Neonatal Medicine
  • Pediatric Nephrology
  • Critical Care

Background:

  • Nephrocalcinosis is a significant concern in preterm infants.
  • Understanding its incidence and etiology is crucial for clinical management.

Purpose of the Study:

  • To prospectively determine the incidence and causes of nephrocalcinosis in preterm infants.
  • To identify risk factors associated with its development.

Main Methods:

  • Prospective observational study of preterm infants (gestation < 32 weeks or birth weight < 1500 g).
  • Renal ultrasound scans at 1 month and term/discharge.
  • Collection of clinical data, medication use (gentamicin, vancomycin, frusemide), fluid/nutrient intake, and laboratory values.
  • Urinary and plasma analyses at term.

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Main Results:

  • 16% of 101 preterm infants developed nephrocalcinosis.
  • Significant associations found with gestational age, male sex, ventilation duration, oxygen dependency, gentamicin exposure (duration, toxicity), dexamethasone use, low fluid intake, and high urinary oxalate/urate excretion.
  • Multivariate analysis identified ventilation duration, toxic drug levels, low fluid intake, and male sex as strongest predictors.

Conclusions:

  • Nephrocalcinosis affects 16% of extremely preterm infants.
  • Multifactorial origins confirmed, linked to prematurity, respiratory disease severity, male sex, gentamicin, and altered urinary excretion.
  • Highlights the need for vigilant monitoring and management of risk factors in this vulnerable population.