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Renal failure, comorbidity and mortality in preterm infants
Dagmar Csaicsich1, Nina Russo-Schlaff, Agnes Messerschmidt
1Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria.
Wiener Klinische Wochenschrift
|March 28, 2008
Summary
Critically ill preterm infants with renal failure face high mortality. Low urine output, organ failure, and extreme prematurity are key risk factors. Further research is needed on the role of dialysis.
Area of Science:
- Neonatalogy
- Pediatric Nephrology
- Critical Care Medicine
Background:
- Renal failure is a serious complication in critically ill preterm infants.
- Risk factors and outcomes for this population are not fully understood, especially for those with extremely low birth weight.
Purpose of the Study:
- To evaluate patient characteristics and mortality risk factors in critically ill preterm infants with renal failure.
- To specifically examine infants with extremely low birth weight.
Main Methods:
- Retrospective cohort study of premature infants treated in a neonatal intensive care unit.
- Inclusion criteria: postnatal serum creatinine >= 1.5 mg/dL and/or urine output < 1 mL/kg/h.
- Five-year follow-up period.
Main Results:
- Sepsis and ischemic events were the most common causes of renal failure.
- Of 16 infants with renal failure, 11 (69%) died from multiorgan failure.
- Low urine output, higher organ failure scores, and low birth weight were significant predictors of mortality.
Conclusions:
- Oliguria/anuria, multiorgan failure, and immaturity are significant mortality risk factors in preterm infants with renal failure.
- Further studies are required to determine if infants died with or from renal failure.
- The potential benefit of dialysis in this population warrants investigation.
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