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Neonatal sepsis and kidney function

Rita Ladeiras, Filipa Flor-de-Lima, Henrique Soares, Bárbara Oliveira, Hercília Guimarães
BACKGROUND: Acute kidney injury (AKI), an abrupt decline in kidney function, is a challenging diagnosis among preterm infants due to some specific features of this population. The aim of this study was to determine the risk factors of developing AKI and the predictive factors for its severity in preterm neonates with less than 31 weeks of gestational age. METHODS: All neonates with less than 31 weeks of gestational age, admitted in our NICU between January 2012 and December 2015, were included...
January 29, 2018: Minerva Pediatrica
A Sow, G Diagne, Y Keita, O Sow, A Ndiath, A Ouattara, M-L Sarr, A Sylla, C Moreira
Female genital mutilation (FGM) comprises all procedures involving partial or total removal of the external genitalia and/or any other procedures affecting the female genitalia, for cultural or religious reasons or for nontherapeutic purposes in general. FGM is responsible for a number of short-, medium-, and long-term complications that can engage the vital and functional prognosis, especially in African countries. We report on a case in a 10-year-old girl who underwent genital mutilation, a traditional type of total excision during the neonatal period...
September 1, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Hitesh Soni, Adebowale Adebiyi
Apoptosis of renal tubular and glomerular cells during kidney disease involves activation of Fas ligand (FasL)-dependent death pathway. The significance of FasL in neonates with septic acute kidney injury (AKI) is unresolved, but an increase in renal FasL production, and/or infiltration of circulating FasL into the kidneys may occur following initial septic insult. Here, we examined whether soluble Fas ligand (sFasL) levels are altered during early phase of septic AKI in neonates. Six hours of polymicrobial sepsis elicited by cecal ligation and puncture (CLP) elevated serum C-reactive protein (CRP) (a bacteremia and sepsis marker) concentration in anesthetized and mechanically ventilated neonatal pigs...
November 2017: Renal Failure
A S Weintraub, J Connors, A Carey, V Blanco, R S Green
OBJECTIVE: To determine risk factors for acute kidney injury (AKI) in preterm infants as a function of time of onset. STUDY DESIGN: In this 5 1/2-year, single-center, retrospective study, incidence and timing of AKI was determined using modified Acute Kidney Injury Network criteria. Characteristics of newborns with and without AKI were compared by chi square and t-tests. Logistic regression was used to examine risk factors for AKI as a function of time of onset and potential confounders...
June 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
A Krishna, R Singh, N Prasad, A Gupta, D Bhadauria, A Kaul, R K Sharma, D Kapoor
Pregnancy-associated acute kidney injury (PAKI) is encountered frequently in developing countries. We evaluated the maternal, fetal and renal outcomes in women with PAKI who needed at least one session of dialysis. Of the total of 98 cases (mean age 28.85 ± 5.13 years; mean parity 2.65 ± 1.28) of PAKI, the most common cause of PAKI was postabortal sepsis. Eighteen patients died; those with oligoanuria, sepsis and central nervous system (CNS) involvement were at greater risk of mortality. The relative risk (RR) of neonatal mortality was lower after with full-term delivery (RR: 0...
March 2015: Indian Journal of Nephrology
Licia Peruzzi, Roberto Bonaudo, Alessandro Amore, Federica Chiale, Maria Elena Donadio, Luca Vergano, Rosanna Coppo
Neonatal sepsis due to E. coli is often complicated by multiple organ failure (MOF) and a high mortality risk. We report the case of a term newborn discharged in good condition who suddenly fell into septic shock after 11 days and required immediate resuscitation, volume expansion and a high-dosage amine infusion. Extremely severe metabolic acidosis, disseminated intravascular coagulation (DIC) with diffuse bleeding, and unstable hemodynamic status with oliguria turned into strict anuria, and the patient became anuric...
May 2014: Case Reports in Nephrology and Urology
Vesna Stojanović, Nenad Barišić, Borko Milanović, Aleksandra Doronjski
BACKGROUND: The factors that contribute to the development of acute kidney injury (AKI) and treatment outcome among prematurely born neonates are not clearly understood. METHODS: This retrospective study included 150 prematurely born neonates. AKI was defined as an increase of serum creatinine levels ≥0.3 mg/dl compared to basal values. RESULTS: The majority of neonates with AKI (94.8 %) had a body weight <1,500 g. Logistic regression analysis showed that the Apgar score in the 5th minute <5, serum lactate levels >5 on the first day of life, core body temperature <36 ºC on the first day of life, occurrence of sepsis, intracranial hemorrhage, necrotizing enterocolitis, patent ductus arteriosus, as well as a treatment with vancomycin or dopamine were independent risk factors for the development of AKI...
November 2014: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Serdar Alan, Duran Yildiz, Omer Erdeve, Ufuk Cakir, Dilek Kahvecioglu, Emel Okulu, Can Ates, Begum Atasay, Saadet Arsan
OBJECTIVES: To describe the efficacy of intravenous colistin on clinical and microbiological outcomes in preterm infants with nosocomial sepsis in neonatal intensive care unit (NICU) and define adverse events observed with this treatment. METHODS: The records of preterm infants who received colistin with or without positive cultures in the NICU were retrospectively reviewed. Patients were evaluated for response to therapy and side effects. RESULTS: A total of 21 preterm infants with medians of 28 weeks (23-36) gestational age and 870 g (620-2,650) birth weight were included...
December 2014: American Journal of Perinatology
Kee Thai Yeo, Archana Priyadarshi, Srinivas Bolisetty
A 6-week-old ex-25-week gestation male infant developed candidal sepsis with subsequent bilateral acute obstructive nephropathy that was not responsive to intravenous antifungal therapy. Bilateral percutaneous nephrotomies were performed and irrigation with fluconazole started. Owing to the persistence of the candidaemia and left renal obstruction, streptokinase was administered through the nephrostomy with eventual resolution of obstruction and improvement in his kidney function. This case report discusses the use of the streptokinase therapy as an adjunct therapy in the clearance of fungal bezoars...
2013: BMJ Case Reports
Fatih Bolat, Serdar Comert, Guher Bolat, Oznur Kucuk, Emrah Can, Ali Bulbul, Hasan Sinan Uslu, Asiye Nuhoglu
BACKGROUND: Although advances in perinatal medicine have increased the survival rates of critically ill neonates, acute kidney injury (AKI) is still one of the major causes of mortality and morbidity in neonatal intensive care units. This study aimed to determine the prevalence of AKI and analyze demographic data and risk factors associated with the mortality or morbidity. METHODS: Of 1992 neonates hospitalized between January 2009 and January 2011, 168 with AKI were reviewed in the study...
November 2013: World Journal of Pediatrics: WJP
Rodney D Gilbert, Priya Sukhtankar, Katherine Lachlan, Darren J Fowler
BACKGROUND: Dominant polycystic kidney disease is common and usually presents clinically in adulthood. Recessive polycystic kidney disease is much less common and frequently presents antenatally or in the neonatal period with severe renal involvement. These are usually thought of as clinically distinct entities but diagnostic confusion is not infrequent. CASE-DIAGNOSIS/TREATMENT: We describe an infant with antenatally diagnosed massive renal enlargement and oligohydramnios with no resolvable cysts on ultrasound scanning...
November 2013: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Yogavijayan Kandasamy, Roger Smith, Ian M R Wright
OBJECTIVES: The incidence of acute kidney injury in neonates is high and associated with up to a 50% mortality rate. The purpose of this review was to determine the feasibility of using serum cystatin C measurements to assist clinicians in making early and accurate diagnoses of acute kidney injury in neonates. DATA SOURCE: We searched for the following seven key words within the PubMed database and the Cochrane Database of Systematic Reviews: cystatin C, neonates, newborn, preterm, premature, kidney failure, and kidney injury...
March 2013: Pediatric Critical Care Medicine
Nurdan Yildiz, Müferet Erguven, Metin Yildiz, Tutku Ozdogan, Pinar Turhan
OBJECTIVE: We aimed to evaluate the efficacy of acute peritoneal dialysis (PD) and clinical outcomes in neonates with acute kidney injury (AKI) and hypernatremic dehydration. ♢ METHODS: The medical records of 15 neonates with AKI and hypernatremic dehydration who were treated with acute PD were reviewed. The diagnoses were AKI with hypernatremic dehydration with or without sepsis in 13 patients and AKI with hypernatremia and congenital nephropathy in 2 patients...
May 2013: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
I Ligi, F Boubred, I Grandvuillemin, U Simeoni
The kidney is a major organ for drug elimination. The function of the neonatal kidney is markedly immature with a reduction of renal blood flow, of glomerular filtration and of active tubular secretion, even in healthy, term infants. Maturation of renal function in particular of glomerular filtration rate is gestational age and postnatal age-dependant. Moreover, many neonatal pathological conditions such as preterm birth, sepsis or perinatal asphyxia can also affect renal function. These developmental changes have a major impact on drug metabolism and elimination...
February 2013: Current Drug Metabolism
Gian Maria Pacifici, Karel Allegaert
Neonatal sepsis is common and is a major cause of morbidity and mortality. Vancomycin is the preferred treatment of several neonatal staphylococcal infections. The aim of this study was to review published data on vancomycin pharmacokinetics in neonates and to provide a critical analysis of the literature. A bibliographic search was performed using PubMed and Embase, and articles with a publication date of August 2011 or earlier were included in the analysis. Vancomycin pharmacokinetic estimates, which are different in neonates compared with adults, also exhibit extensive inter-neonatal variability...
July 2012: Clinics
P Manzoni, P Galletto, S Rizzollo, C Franco, E Gallo, R Antonucci, V Fanos, D Farina
BACKGROUND: Liposomal amphotericin B (LAMB) is frequently administered in NICU to preterm infants <1500 g at birth (VLBW) for treatment of systemic fungal infections (SFI). Concerns exist on safety and tolerability of such drug in patients who are at risk for renal function impairment due to their prematurity. AIM: To assess the occurrence of renal function impairment related to LAMB in a 10-year cohort of VLBW neonates treated with this drug. METHODS: Through database search of clinical charts, all VLBW neonates admitted to a 3(rd) level NICU in the years 1998-2007 and undergoing treatment with LAMB were identified...
May 2012: Early Human Development
Iwona Maruniak-Chudek, Teresa Owsianka-Podleśny, Jolanta Wróblewska, Danuta Jadamus-Niebrój
INTRODUCTION: Several studies have claimed that the estimation of serum cystatin C could be a better marker of kidney excretory function than serum creatinine. However, its role in the diagnosis of reduced kidney function was not unquestionably confirmed. The aim of this study was to analyze the concentrations of serum cystatin C in neonates with sepsis. MATERIAL/METHODS: Thirty-two neonates (gestational age from 34 to 40 weeks) admitted to the NICU during the first 14 days of life were enrolled...
2012: Postȩpy Higieny i Medycyny Doświadczalnej
R Marahatta, B Acharya Dhungel, P Pradhan, S K Rai, D Roy Choudhury
Urinary tract infection is the commonest bacterial infection in pregnancy. The overall incidence is 5.0-10.0% of all pregnancy. During pregnancy bacterial growth is favoured by increased urinary content of glucose, aminoacids and other nutrients. Other factors responsible for infection are basically related to hormonal effect and mechanical factors. Prolonged stasis of urine in urinary bladder favours growth of micro organism, relaxation of vesico-ureteric junction leads to reflux of urine from bladder to ureter and later up to renal pelvis and later can affect the renal parenchyma affecting the function of kidneys...
June 2011: Nepal Medical College Journal: NMCJ
Gaetano La Manna, Silvia Galletti, Irene Capelli, Silvia Vandini, Katia Nisi, Giulia Aquilano, Rita Mancini, Elisa Carretta, Giovanni Montini, Giacomo Faldella, Sergio Stefoni
Preterm infants are exposed to conditions that can impair renal function. We evaluated the ability of serum and urinary neutrophil gelatinase-associated lipocalin (sNGAL and uNGAL) to predict renal function in the first weeks of life. From September 2008 to July 2009, infants weighing ≤1500 g at birth with no major congenital anomalies or sepsis were eligible. We measured sNGAL and uNGAL levels at birth. To evaluate renal function, we determined changes in serum creatinine (sCreat) and estimated GFR (eGFR) from birth to d 21...
October 2011: Pediatric Research
Sarar Mohamed, Ebtisam El-Meleagy, Abdelhaleem Nasr, Merel S Ebberink, Ronald J A Wanders, Hans R Waterham
Peroxisomal biogenesis disorders (PBD) are groups of inherited neurometabolic disorders caused by defects in PEX genes. We report on a female infant, born to a consanguineous parents (first degree cousins), who presented with inactivity, poor sucking, and hypotonia early in the neonatal period. She had subtle dysmorphic features. Liver function tests were impaired with raised liver enzymes, conjugated and unconjugated hyperbilirubinemia. CT of the brain showed diffuse bilateral changes. She developed seizures with an abnormal EEG...
September 2010: American Journal of Medical Genetics. Part A
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