Acute renal failure SNAPPE and mortality

Area of Science:

• Neonatalogy
• Pediatric Nephrology
• Critical Care Medicine

Background:

• Acute renal failure (ARF) is a significant concern in newborns, impacting outcomes.
• Early identification of neonates at risk for ARF is crucial for timely intervention.
• The Score for Neonatal Acute Physiology and Perinatal Extension II (SNAPPE-II) is a tool used to assess neonatal illness severity.

Purpose of the Study:

• To investigate the association between SNAPPE-II scores on the first day of life and the development of ARF in newborns.
• To determine if SNAPPE-II can identify neonates at risk for ARF before an increase in serum creatinine levels is detected.

Main Methods:

• A retrospective study involving 553 newborns, divided into ARF (n=78) and non-ARF (n=475) groups.
• SNAPPE-II scores and postnatal risk factors were collected on day one of life.
• ARF was defined by serum creatinine levels exceeding specific thresholds after 48 hours of life.

Main Results:

• Newborns with ARF exhibited significantly higher median SNAPPE-II scores and mortality rates compared to the control group.
• Independent predictors for ARF included patent ductus arteriosus (PDA), disseminated intravascular coagulation (DIC), SNAPPE-II, and resuscitation.
• Predictors of mortality were sepsis, respiratory distress syndrome, ARF, DIC, and SNAPPE-II.

Conclusions:

• Higher SNAPPE-II scores on day one are associated with an increased risk of ARF and mortality in neonates.
• Despite the association, SNAPPE-II scores at admission were not found to improve the prediction of ARF before creatinine elevation.