[Determinants of uremia elevation in the first days of life in premature infants born before 30 weeks of gestation].
OBJECTIVE
To identify the determinants associated with uremia elevation in the first days of life in extremely premature infants.


METHODS
We performed a prospective cohort study in a cohort of neonates born at less than 30 weeks of gestation.


RESULTS
Forty-eight preterm infants were included, of which 10 died. The mean fluid administration was 55, 72, 88 and 124 mL/kg on the first, second, third and seventh days of life. Amino acid doses were low in the first two days of life and were unrelated to uremia elevation. Thirty-one percent of the infants presented hypernatremia. Uremia was measured in 31 infants between the fifth and tenth days of life and 12 infants (38.7 %) had uremia values of 100 mg/dL or higher, without creatinine elevation. All of these infants were born at less than 27 weeks of gestation, weighed less than 850 grams at birth, and showed greater weight loss (19.2 % vs. 13.8 %; p 5 0.037) and higher natremia (150.2 mEq/L vs. 146.6 mEq/L; p 5 0.023). The use of furosemide increased the risk of elevated uremia (relative risk: 2.54; 95 % confidence interval: 1.05 6.14).


CONCLUSIONS
Total uremia of 100 mg/dL or higher was associated with dehydration, greater weight loss, higher natremia, furosemide use, lower gestational age, and lower birth weight.
Bustos Lozano
G
G
Servicio de Neonatología. Hospital Universitario 12 de Octubre. Madrid. España. gbustos.hdoc@salud.madrid.org
Orbea Gallardo
C
C
Fernández de Miguel
S
S
Muñoz Labián
M C
MC
López Maestro
M
M
Moral Pumarega
M
M
D000367:Age Factors; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D014511:Uremia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*