title: Postnatal trends in creatinemia and its covariates in extremely low birth weight (ELBW) neonates.
abstract: To document trends and covariates of creatinemia (Scr) in extremely low birth weight (ELBW, < 1,000 g) neonates, maternal characteristics [betamethasone, premature preterm rupture of membranes (PPROM), pre-eclampsia, maternal Scr], characteristics at delivery [gestational age (GA), birth weight (BW), small for GA (SGA), Apgar, intubation] and during neonatal stay [ventilation, oxygen, parenteral nutrition, ibuprofen, steroids, intraventricular hemorrhage, retinopathy of prematurity (ROP), phototherapy] were linked with Scr observations. Data were reported by median and range or incidence. Characteristics in ELBW neonates with raised peak Scr (>P75) were compared to controls (<P75). In 151 ELBW neonates, an initial increase in Scr was observed, resulting in a peak Scr on day 3 or 4 of 99.9 (46.8-221.8) μmol/l with subsequent decrease. In cases (n  = 37) with a peak Scr >P75 (112.3 μmol/l), Scr remained elevated until day 28. Mothers of cases received less betamethasone, neonates had a lower GA, lower BW, lower Apgar, and needed more often intubation. Postnatal ventilation, oxygen, parenteral nutrition, ibuprofen, steroids, ROP, and intraventricular hemorrhage were different. GA and ventilation or Apgar were independent factors for raised peak Scr. ELBW neonates display trends similar to heavier neonates, but peak Scr is higher, and the subsequent decrease slower. Raised creatinemia in ELBW neonates reflects immaturity (GA) and morbidity (ventilation, Apgar).
authors.affiliation: Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Isabel
authors.initials: I
authors.lastname: George
authors.forename: Djalila
authors.initials: D
authors.lastname: Mekahli
authors.forename: Maissa
authors.initials: M
authors.lastname: Rayyan
authors.forename: Elena
authors.initials: E
authors.lastname: Levtchenko
authors.forename: Karel
authors.initials: K
authors.lastname: Allegaert
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001034:Apgar Score; D001724:Birth Weight; D015331:Cohort Studies; D003401:Creatine / Q000097:blood*; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007223:Infant; D052577:Infant, Extremely Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008297:Male; D012121:Respiration, Artificial; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D003401:Creatine; D007052:Ibuprofen