Critical serum creatinine values in very preterm newborns.

Details

Serval ID
serval:BIB_1546D84039E7
Type
Article: article from journal or magazin.
Collection
Publications
Title
Critical serum creatinine values in very preterm newborns.
Journal
Plos One
Author(s)
Bruel A., Rozé J.C., Flamant C., Simeoni U., Roussey-Kesler G., Allain-Launay E.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
8
Number
12
Pages
e84892
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: epublish
Abstract
BACKGROUND: Renal failure in neonates is associated with an increased risk of mortality and morbidity. But critical values are not known.
OBJECTIVE: To define critical values for serum creatinine levels by gestational age in preterm infants, as a predictive factor for mortality and morbidity.
STUDY DESIGN: This was a retrospective study of all preterm infants born before 33 weeks of gestational age, hospitalized in Nantes University Hospital NICU between 2003 and 2009, with serum creatinine levels measured between postnatal days 3 to 30. Children were retrospectively randomized into either training or validation set. Critical creatinine values were defined within the training set as the 90(th) percentile values of highest serum creatinine (HSCr) in infants with optimal neurodevelopmental at two years of age. The relationship between these critical creatinine values and neonatal mortality, and non-optimal neural development at two years, was then assessed in the validation set.
RESULTS AND CONCLUSION: The analysis involved a total of 1,461 infants (gestational ages of 24-27 weeks (n=322), 28-29 weeks (n=336), and 30-32 weeks (803)), and 14,721 creatinine assessments. The critical values determined in the training set (n=485) were 1.6, 1.1 and 1.0 mg/dL for each gestational age group, respectively. In the validation set (n=976), a serum creatinine level above the critical value was significantly associated with neonatal mortality (Odds ratio: 8.55 (95% confidence interval: 4.23-17.28); p<0.01) after adjusting for known renal failure risk factors, and with non-optimal neurodevelopmental outcome at two years (odds ratio: 2.06 (95% confidence interval: 1.26-3.36); p=0.004) before adjustment. Creatinine values greater than 1.6, 1.1 and 1.0 mg/dL respectively at 24-27, 28-29, 30-32 weeks of gestation were associated with mortality before and after adjustment for risk factors, and with non-optimal neurodevelopmental outcome, before adjustment.
Pubmed
Web of science
Open Access
Yes
Create date
22/02/2015 9:00
Last modification date
20/08/2019 12:44
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