Buradasınız

Doğu Anadolu Bölgesi’nde Yenidoğan Döneminde Akut Böbrek Yetmezliği

Acute Renal Failure in the Neonatal Period in the Eastern Anatolia Region

Journal Name:

Publication Year:

DOI: 
DOI 10.5262/tndt.2012.1003.15

Keywords (Original Language):

Abstract (2. Language): 
OBJECTIVE: To evaluate the clinical and laboratory characteristics of acute kidney injury (AKI) in newborns followed up in our neonatal intensive care unit (NICU). MATERIAL and METHODS: This prospective study was performed in 59 newborns referred to our NICU through the completion of previously prepared forms. The Mann-Whitney U test and Student t-test were used for statistical analysis. Ethical committee approval was obtained for the study. RESULTS: Eight hundred eighteen newborns were followed up in our NICU during the study period, 59 of whom (7.2%) were diagnosed as AKI. In terms of type of renal failure, 80% of the cases had prerenal AKI, 17% had renal AKI and 3% had postrenal AKI. Eighty-three percent of cases with prerenal AKI had dehydration secondary to breast-feeding malnutrition. Thirty percent of cases with renal AKI had prolonged prerenal AKI. The clinical course of AKI was oliguric/unuric in 43 cases. Mortality rate was 1.7%. CONCLUSION: These results show that the most important cause of AKI in our region is inadequate breast-feeding. We think that this problem can be signifi cantly reduced by mothers receiving adequate training regarding breast-feeding and its importance during pregnancy and after delivery, and that babies should be discharged once the physician is sure that they are breast-fed adequately by their mothers.
Abstract (Original Language): 
AMAÇ: Yenidoğan yoğun bakım ünitemize (YYBÜ) yatırılarak takip edilen akut böbrek hasarı (ABH) olan yenidoğanların klinik ve laboratuvar özelliklerini değerlendirmek. GEREÇ ve YÖNTEMLER: Bu ileriye dönük çalışma, YYBÜ’mize yatırılarak tedavileri planlanan 59 ABH’li yenidoğana önceden hazırlanmış olan formlar doldurularak gerçekleştirildi. İstatistiksel analiz için Mann-Whitney U ve Student t-testleri kullanıldı. Çalışma için etik kurul onayı alındı. BULGULAR: Çalışma süresince YYBÜ’nde izlenen 818 bebekten 59’u (%7,2) ABH tanısı aldı. Böbrek hasarı vakaların %80’inde prerenal, %17’sinde renal ve %3’ünde postrenal idi. Prerenal hasarlı vakaların %83’ünde etken beslenme bozukluğuna ikincil gelişen dehidratasyon idi. Renal hasarlı vakaların % 30’u ise uzamış prerenal hasara ikincil renal ABH idi. Akut böbrek hasarı 43 olguda oligürik/anürik seyir gösterdi. Mortalite oranı %1,7 olarak saptandı. SONUÇ: Bu sonuçlar, bölgemizde ABH’nin en önemli nedeninin yetersiz anne sütü alımı olduğunu göstermektedir. Anne adaylarının, gebelik süreci ve doğum sonrası emzirme ve anne sütünün önemi konularında eğitilmelerinin ve bebeklerin anneleri tarafından yeterince beslenebildiklerinden emin olunduktan sonra taburcu edilmesinin bu sorunu önemli ölçüde azaltacağı kanısındayız.

REFERENCES

References: 

1. Andreoli SP: Acute kidney injury in children. Pediatr Nephrol 2009;
24: 253-263
2. Alpay H, Bıyıklı NK, Gökçe İ, Bilgen H, Özek E, Akman İ:
Yenidoğan bebeklerde akut böbrek yetersizliği. Acute renal failure
in neonatal period. Turk Neph Dial Transpl 2006; 15: 29-36
3. Gouyon JB, Guignard JP: Management of acute renal failure in
newborns. Pediatr Nephrol 2000; 14: 1037-1044
4. Mathur NB, Agarwal HS, Maria A: Acute renal failure in neonatal
sepsis. Indian J Pediatr 2006; 73: 499-502
5. Agras PI, Tarcan A, Baskin E, Cengiz N, Gürakan B, Saatci U:
Acute renal failure in the neonatal period. Ren Fail 2004; 26: 305-
309
6. Aggarwal A, Kumar P, Chowdhary G, Majumdar S, Narang A:
Evaluation of renal functions in asphyxiated newborns. J Trop
Pediatr 2005; 51: 295-299
7. Norman ME, Asadi FK: A prospective study of acute renal failure in
the newborn infant. Pediatrics 1979; 63: 475-479
8. Askenazi DJ, Ambalavanan N, Goldstein SL: Acute kidney injury
in critically ill newborns: What do we know? What do we need to
learn? Pediatr Nephrol 2009; 24: 265-274
9. Zubrow AB, Hulman S, Kushner H, Falkner B: Determinants of
blood pressure in infants admitted to neonatal intensive care units:
A prospective multicenter study. Philadelphia Neonatal Blood
Pressure Study Group. J Perinatol 1995; 15: 470-479
10. Ishizaki Y, Isozaki-Fukuda Y, Kojima T, Sasai M, Matsuzaki S,
Kobayashi Y: Evaluation of diagnostic criteria of acute renal failure
in premature infants. Acta Paediatr Jpn 1993; 35: 311-315
11. Karlowicz MG, Adelman RD: Acute renal failure in the neonate.
Clin Perinatol 1992; 19: 139-158
12. Nafday SM, Brion PL, Corinne B, Satlin LM, Flynn JT, Edelmann
CM: Renal Disease. In MacDonald MG, Mullett MD, Seshia MMK
(eds.), Avery’s Neonatology. (6th ed). Philadelphia: Lippincott
Williams&Wilkins, 2005; 981-1065
13. Arant BS Jr: Developmental patterns of renal functional maturation
compared in the human neonate. J Pediatr 1978: 92: 705-712
14. Airede A, Bello M, Weerasinghe HD: Acute renal failure in the
newborn: Incidence and outcome. J Paediatr Child Health 1997; 33:
246-249
15. Mortazavi F, Hosseinpour Sakha S, Nejati N: Acute kidney failure
in neonatal period. Iran J Kidney Dis 2009; 3: 136-140
16. Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP: Renal failure in
asphyxiated neonates. Indian Pediatr 2005; 42: 928-934
17. Livingstone VH, Willis CE, Abdel-Wareth LO, Thiessen P, Lockitch
G: Neonatal hypernatremic dehydration associated with breastfeeding
malnutrition: A retrospective survey. CMAJ 2000; 162:
647-652
18. Neifert MR: Prevention of breastfeeding tragedies. Pediatr Clin
North Am 2001; 48: 273-297
19. Tunçbilek E: Türkiye’deki yüksek nöral tüp defekti sıklığı ve
önlemek için yapılabilecekler. (The high incidence of neural tube
defectsin Turkey what should be done for prevention?). Çocuk
Sağlığı ve Hastalıkları Dergisi 2004; 47: 79-84
20. Bauer SB: Neurogenic bladder: Etiology and assessment. Pediatr
Nephrol 2008; 23: 541-551
21. Khoory BJ, Andreis IA, Vino L, Fanos V: Transient
hyperechogenicity of the renal medullary pyramids: Incidence in
the healthy term newborn. Am J Perinatol 1999; 16: 463-468
22. Howlett DC, Greenwood KL, Jarosz JM, MacDonald LM, Saunders
AJ: The incidence of transient renal medullary hyperechogenicity in
neonatal ultrasound examination. Br J Radiol 1997; 70: 140-143
23. Makhoul IR, Soudack M, Smolkin T, Sujov P, Epelman M,
Eisenstein I, Magen D, Zelikovic I: Neonatal transient renal failure
with renal medullary hyperechogenicity: Clinical and laboratory
features. Pediatr Nephrol 2005; 20: 904-909
24. Ali US, Sengupta K, Andankar P, Saraf S, Chawla A, Deshpande
S: Reversible renal medullary hyperechogenicity in neonatal
hypernatremic dehydration. Pediatr Nephrol 2004; 19: 1050-1052
25. Riebel TW, Abraham K, Wartner R, Müller R: Transient renal
medullary hyperechogenicity in ultrasound studies of neonates: Is
it a normal phenomenon and what are the causes? Clin Ultrasound
1993; 21: 25-31
26. Çelik T, Fırat AK, Kahraman AS, Erdem G, Karkaş HM, Yakıcı C:
Akut böbrek yetmezlikli ve dehidratasyonlu yenidoğanların geçici
renal medüller hiperekojenitesi: Ultrasonografi izlemi. (Transient
renal medullary hyperechogenicity in newborns with acute renal
failure and dehydration: Ultrasonography follow-up). Çocuk Sağlığı
ve Hastalıkları Dergisi 2006; 49: 291-295
27. Andreoli SP: Acute renal failure in the newborn. Semin Perinatol
2004; 28: 112-123

Thank you for copying data from http://www.arastirmax.com