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Boletín médico del Hospital Infantil de México
Print version ISSN 1665-1146
Abstract
SANCHEZ, Carlos; GARCIA, Miguel A. and VALDES, Ben D.. Acute kidney injury in newborns with necrotizing enterocolitis: risk factors and mortality. Bol. Med. Hosp. Infant. Mex. [online]. 2019, vol.76, n.5, pp.210-214. Epub Mar 13, 2020. ISSN 1665-1146. https://doi.org/10.24875/bmhim.19000044.
Background:
Both necrotizing enterocolitis and acute kidney injury are tightly related conditions, which independently increase mortality in newborns. Necrotizing enterocolitis is an inflammatory disease with a systemic repercussion that leads to inflammatory kidney changes predisposing to renal damage.
Methods:
This study assessed risk factors for the development of acute kidney injury in patients diagnosed with necrotizing enterocolitis and compared mortality between patients with or without acute kidney injury. Thirty-nine patients with the diagnosis of necrotizing enterocolitis were included, regardless of the gestational age.
Results:
Of 39 patients, 38.5% developed acute kidney injury. Survival showed to be significantly lower in patients with acute kidney injury (54.4 days) when compared to newborns without acute kidney injury (76.22 days; p = 0.014). Mortality in patients with acute kidney injury was 46.7%, increasing up to 62.5% with severe kidney damage. The hazard ratio for mortality was 4.708 for acute kidney injury (p = 0.025). The severity of enterocolitis showed to be an independent risk factor in developing acute kidney injury and severe kidney injury (odds ratio [OR] = 1.841, p = 0.034 and OR = 1.917, p = 0.027, respectively).
Conclusions:
Newborns with necrotizing enterocolitis should be evaluated for early recognition of acute kidney injury. Prospective studies with a higher number of patients are needed to identify modifiable risk factors to impact in the prevention of these conditions.
Keywords : Acute kidney injury; Necrotizing enterocolitis; Mortality; Risk factors.