• The role of the rapeutic procedures in the formation of acute kidney injury of term newborns with severe perinatal pathology 

The role of the rapeutic procedures in the formation of acute kidney injury of term newborns with severe perinatal pathology 

PERINATOLOGIYA I PEDIATRIYA. 2016.2(66):122-127; doi 10.15574/PP.2016.66.122 
 

The role of the rapeutic procedures in the formation of acute kidney injury of term newborns with severe perinatal pathology 
 

Babintseva А. G.

HSEEU «Bukovinina State Medical University», Chernivtsi, Ukraine 
 

Purpose — to study associations between the character of the rapeutic procedures and formation of acute kidney injury in term newborns with severe perinatal pathology in early neonatal period. 
 

Patients and methods. A comprehensive clinical-paraclinical examination of 95 term newborns with clinical signs of severe perinatal pathology has been carried out, including 65 of them with disorders of the renal functional condition, and 30 — with acute kidney injury. To detect the connection between the character of therapeutic procedures and development of AKI a logistic regression analysis has been conducted with calculation of chance correlation (CC) and 95% of confidence interval (95% CI). 
 

Results. Postnatal factors aggravating renal dysfunction and increasing the risk of acute kidney injury formation in critically sick term babies have been found to be: the use of oxygen therapy with free flow (CC 3.13; 95% CI 1.059–9.225, р<0.05), loop diuretics (CC 15.8; 95% CІ 4.035–61.901, р<0.05), medicines with inotropic action (CC 9.0; 95% CІ 3.187–25.41, р<0.05), antispasmodic drugs (CC 17.38; 95% CІ 3.818–79.117, р<0.05), fresh frozen plasma (CC 5.14; 95% CІ 1.548–17.09) against the application of ventilation support and combined antibiotic therapy. Term newborns with signs of ARL in comparison with babies having the signs of renal functional state disorders against severe perinatal pathology have statistically considerably higher average estimation according to Neonatal Therapeutic Intervention Scoring System during early neonatal period (15.1±3.2 score and 11.3±2.84 score respectively, р<0.05).


Conclusions. The use of therapeutic procedures aggravates unfavourable effects of hypoxic renal lesion and increases the risk of acute kidney injury formation in term newborns with severe perinatal pathology, which is associated with oxidative stress, disorders of central and peripheral hemodynamic mechanisms, direct cellular lesions of the glomerular membrane and canalicular nephrothelium.


Key words: acute kidney injury, term newborns, mechanical lung ventilation, oxygen therapy, inotrops, aminoglycosides, diuretics.


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