Renal failure, comorbidity and mortality in preterm infants.
OBJECTIVE
To evaluate patient characteristics and risk factors for mortality in critically ill preterm infants with renal failure, with a special focus on infants with extremely low birth weight.


METHODS
Retrospective cohort study with five year follow-up of all premature infants who were treated in the neonatal intensive care unit in 2002 and developed postnatal serum creatinine > or =1.5 mg/dl and/or urine output <1 ml/kg per h.


METHODS
Tertiary Care University Hospital of the Medical University of Vienna


METHODS
Sixteen of 359 premature infants (9 boys, 7 girls) fulfilled the inclusion criteria for renal failure. Their median gestational age was 30 weeks (range 24-36) with a median birth weight of 811.5 g (range 588-2662).


RESULTS
The most common causes of renal failure were sepsis and ischemic events. All infants were managed conservatively with corrections of fluids, electrolytes and acidosis, including medication with diuretics and dopamine. Eleven infants with renal failure (69%) died in multiorgan failure. Infants with low urine output, higher scores for failed organs or low birth weight were significantly more likely to die. Infants with very low birth weights had higher scores for failed organs (all P < 0.05).


CONCLUSIONS
Oliguria/anuria, multiorgan failure and immaturity were significant risk factors for mortality in preterm infants with renal failure. Further studies and/or more registry data are needed to determine whether these infants died with or from renal failure, and whether dialysis would improve outcome in this special population.
Csaicsich
Dagmar
D
Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria.
Russo-Schlaff
Nina
N
Messerschmidt
Agnes
A
Weninger
Manfred
M
Pollak
Arnold
A
Aufricht
Christoph
C
D058186:Acute Kidney Injury / Q000401:mortality* / Q000628:therapy; D001317:Austria; D002423:Cause of Death; D002675:Child, Preschool; D015331:Cohort Studies; D003401:Creatine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality* / Q000628:therapy; D015931:Intensive Care, Neonatal; D007677:Kidney Function Tests; D008297:Male; D009102:Multiple Organ Failure / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
D003401:Creatine