当前位置: X-MOL 学术Pediatr. Nephrol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Prognostic role of acute kidney injury on long-term outcome in infants with hypoxic-ischemic encephalopathy.
Pediatric Nephrology ( IF 2.6 ) Pub Date : 2019-12-11 , DOI: 10.1007/s00467-019-04406-4
Francesco Cavallin 1 , Giulia Rubin 2 , Enrico Vidal 3 , Elisa Cainelli 4 , Luca Bonadies 2 , Agnese Suppiej 2, 5 , Daniele Trevisanuto 2
Affiliation  

BACKGROUND The objective of this study was to evaluate the prognostic role of postnatal acute kidney injury (AKI) on neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH). METHODS This is a prospective observational study including all neonates with HIE receiving TH between 2009 and 2016 at a single center. AKI was classified according to the Kidney Disease: Improving Global Outcomes definition modified for neonatal age. Child development was assessed using the Griffiths Mental Development Scales (GMDS). Study outcome was defined as unfavorable outcome (including death or disability according to GMDS) or favorable otherwise, at 12 and 24 months. RESULTS One-hundred and one neonates (median gestational age 39 weeks) were included. AKI was diagnosed in 10 neonates (10%). Seven patients died within the first year, 35 patients had disability at 12 months, and 45 patients at 24 months. AKI was associated with increased likelihood of unfavorable outcome at 24 months (100% vs. 59% in neonates without AKI; p = 0.01). AKI showed good positive predictive value (1.00, 95% CI 0.71-1.00) and specificity (1.00, 95% CI 0.88-1.00), but poor negative predictive value (0.41, 95% CI 0.30-0.52) and sensitivity (0.19, 95% CI 0.11-0.32) at 24 months. CONCLUSIONS AKI might be a reliable indicator of death or long-term disability in infants with HIE receiving TH, but the absence of AKI does not guarantee a favorable long-term outcome.

中文翻译:

急性缺氧缺血性脑病患儿急性肾脏损伤对长期预后的预后作用。

背景技术这项研究的目的是评估出生后急性肾损伤(AKI)对接受治疗性体温过低(TH)的缺氧缺血性脑病(HIE)婴儿神经发育结局的预后作用。方法这是一项前瞻性观察性研究,其中包括2009年至2016年之间在单个中心接受过TH的所有HIE新生儿。根据肾脏疾病对AKI进行了分类:针对新生儿年龄修改了“改善总体结果”定义。使用格里菲思精神发育量表(GMDS)评估儿童发育。研究结果定义为在12和24个月时的不利结果(包括根据GMDS的死亡或残疾)或其他情况的有利结果。结果纳入一百零一新生儿(中位胎龄为39周)。在10例新生儿中诊断出AKI(10%)。在第一年内有7名患者死亡,在12个月时有35例残疾,在24个月时有45例残疾。AKI与24个月时不良结局的可能性增加相关(100%对比无AKI的新生儿为59%; p = 0.01)。AKI表现出良好的阳性预测值(1.00,95%CI 0.71-1.00)和特异性(1.00,95%CI 0.88-1.00),但不良的阴性预测值(0.41,95%CI 0.30-0.52)和敏感性(0.19,95) 24个月时的%CI 0.11-0.32)。结论AKI可能是接受TH的HIE婴儿死亡或长期残疾的可靠指标,但是缺乏AKI不能保证长期的良好结局。没有AKI的新生儿中有59%;p = 0.01)。AKI表现出良好的阳性预测值(1.00,95%CI 0.71-1.00)和特异性(1.00,95%CI 0.88-1.00),但不良的阴性预测值(0.41,95%CI 0.30-0.52)和敏感性(0.19,95) 24个月时的%CI 0.11-0.32)。结论AKI可能是接受TH的HIE婴儿死亡或长期残疾的可靠指标,但缺乏AKI不能保证长期的良好结局。没有AKI的新生儿中有59%;p = 0.01)。AKI表现出良好的阳性预测值(1.00,95%CI 0.71-1.00)和特异性(1.00,95%CI 0.88-1.00),但不良的阴性预测值(0.41,95%CI 0.30-0.52)和敏感性(0.19,95) 24个月时的%CI 0.11-0.32)。结论AKI可能是接受TH的HIE婴儿死亡或长期残疾的可靠指标,但是缺乏AKI不能保证长期的良好结局。
更新日期:2020-01-17
down
wechat
bug