Functional state of the kidneys in the neonatal period in children with very low and extremely low body weight

N. Korotaeva, T. L. Nastausheva, L. I. Ippolitova
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Abstract

BACKGROUND. Preterm birth is still associated with an increased risk of neonatal morbidity and mortality in the early neonatal period. There is strong evidence demonstrating an association between a decrease in the number of nephrons in preterm infants and an increase in blood pressure, the risk of developing chronic kidney disease, which undoubtedly negatively affects the quality of life. THE AIM: to assess the functional state of the kidneys in children with very low (VLBW) and extremely low body weight (ELBW) in the first 8 weeks of postnatal life. PATIENTS AND METHODS. The study involved 134 newborns less than 37 weeks of gestation, who were divided into three groups depending on birth weight. The levels of protein and fluid intake, serum creatinine concentration, GFR according to Schwartz were taken into account as evaluation parameters. The Python programming language, t-tests, ShapiroWilk and d'Agostino tests were used as statistical methods. A threshold level of 0.05 was chosen to interpret the value of p tests for normality testing. RESULTS. There were no differences in the amount of protein received by preterm infants in the study groups both in the first week and subsequent 2–8 weeks of life. The average level of incoming fluid in the first week of postnatal life increased from 1 to 7 days in all study groups. There was a trend towards a more significant decrease in serum creatinine in children born with a larger birth weight. Analyzing the level of glomerular filtration rate in the studied groups, there is a clear picture of a progressive increase in the rate with age. CONCLUSION. The values of diuresis, creatinine level and GFR in premature babies with birth weight less than 1500 grams in the first 2 months of life have been established, which can be used in practice for comparison in the study of various pathologies.
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极低和极低体重儿童新生儿期肾脏功能状态的研究
背景。早产仍与新生儿早期发病和死亡风险增加有关。有强有力的证据表明,早产儿肾单位数量减少与血压升高、患慢性肾脏疾病的风险增加之间存在关联,这无疑会对生活质量产生负面影响。目的:评估极低(VLBW)和极低体重(ELBW)儿童在出生后前8周的肾脏功能状态。患者和方法。这项研究涉及134名怀孕不到37周的新生儿,根据出生体重将他们分成三组。蛋白质和液体摄入量水平,血清肌酐浓度,GFR根据Schwartz被考虑作为评价参数。统计学方法采用Python编程语言、t检验、ShapiroWilk检验和d’agostino检验。选择0.05的阈值水平来解释p检验的正态性检验值。结果。在第一周和随后的2-8周内,研究组早产儿接受的蛋白质量没有差异。在所有研究组中,出生后第一周的平均液体水平从1天增加到7天。在出生体重较大的儿童中,血清肌酐有更显著下降的趋势。通过分析实验组的肾小球滤过率水平,可以清楚地看到随着年龄的增长,肾小球滤过率呈进行性增加的趋势。结论。已确定出生体重小于1500克的早产儿在出生后2个月的利尿、肌酐水平和GFR值,可在实践中用于各种病理研究的比较。
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