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Postnatal trends in creatinemia and its covariates in extremely low birth weight (ELBW) neonates

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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).

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Acknowledgements

Elena Levtchenko and Karel Allegaert are supported by the Fund for Scientific Research, Flanders (Belgium) (F.W.O. Vlaanderen) by a Fundamental Clinical Investigatorship (1801110 N and 1800209 N).

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Authors and Affiliations

  1. Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium

    Isabel George, Djalila Mekahli & Elena Levtchenko

  2. Neonatal Intensive Care Unit, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Maissa Rayyan & Karel Allegaert

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  1. Isabel George
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  2. Djalila Mekahli
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  3. Maissa Rayyan
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  4. Elena Levtchenko
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  5. Karel Allegaert
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Correspondence to Karel Allegaert.

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George, I., Mekahli, D., Rayyan, M. et al. Postnatal trends in creatinemia and its covariates in extremely low birth weight (ELBW) neonates. Pediatr Nephrol 26, 1843–1849 (2011). https://doi.org/10.1007/s00467-011-1883-0

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  • DOI: https://doi.org/10.1007/s00467-011-1883-0

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