P1816KIDNEY DAMAGE IN NECROTIZING ENTEROCOLITIS OF PREMATURE BORN INFANTS

Abstract

Abstract Background and Aims Neonatal kidney damage can be the result of hypoxic-ischemic events or nephrotoxic drugs. The long-term effects of hypoxia on the kidneys are still unclear. Unlike full-term infants, premature infants of less than 36 weeks of gestational age exhibit persistent nephrogenesis According to literature database, ischemia as well as reperfusion and infection (hypoxia, acidosis, hypotension, the action of free oxygen radicals) are also major risk factors for necrotizing enterocolitis (NEC). The aim is to establish the peculiarities of kidney damage in necrotizing enterocolitis of premature infants who died from it and infants with NEC surviving. Method The study involved 54 of premature infants: 21 infants with NEC stage II and III who died (group A), 43 infants who survived with similar stages of NEC (group B). Statistical processing of the data obtained was carried out on a personal computer using STATISTICA 6.1 and IBM SPSS. Results Infants in group A had significantly higher body weight - (1371.2±70.5) g than infants in group B - (1163.9±51.6) g (p<0.05). Gender peculiarities were established: boys (66.7%) were significantly more prevalent in group A, i.e. there were twice more boys among the dead (χ2 = 7.679; p = 0.006). In 85.7% children with NEC stage II and III who died was diagnosed perinatal hypoxia and 90.5% infants of this group have perinatal infections, p<0.01. The level of serum urea and creatinine in children with NEC who died was significantly higher (21.2±2.9 mmol/l and 175.8±23.7 μmol/l respectively) than in premature infants who survived with NEC (6.8±0.6 mmol/l and 76.0±6.9 μmol/l, respectively), (p<0.01). Odds ratio (OR) of lethal outcome in premature infants with NEC and elevated levels of urea (OR = 12.364; 95% CI: 3.415–44.768) and creatinine (OR = 8.267; 95 % CI: 2.447-27.589). In premature infants who died, one of the most frequent causes of death was acute kidney damage - in 8 (38.1%) infants, among other causes one of the most common causes was endogenous intoxication in 8 (38.1%) infants, rarely other causes. Conclusion Hypoxia and infections during pregnancy and during the birth of premature infants played a significant role in develop of kidney damage. Elevated levels of urea and creatinine in premature infants with NEC one of the factors that associated with mortality.