Abstract
Objective: Acute kidney injury is an important problem in neonates. We conducted a cross-sectional prospective study to determine normal serum blood urea nitrogen, creatinine reference ranges and ranges of ultrasonographic measurement of kidneys in healthy term newborns.Study Design: Blood samples were collected from total 357 healthy newborns at birth (n=45), 1st (n=30), 3rd (n=61), 7th (n=34), 10th (n=132), 14th (n=36), and 28th (n=19) days of life. Renal ultrasonographic was performed by the same two radiologists on 81 newborns aged 10 days. Results: Serum blood urea nitrogen and creatinine concentrations have reached to the highest level at the first day of life and have returned to cord level at the third day of life. There were gradually decrease in serum blood urea nitrogen and creatinine levels after the first day of life. There were significant difference in both right and left renal length, width, and volumes in terms of gender and these parameters were statistically higher in boys than girls (p<0.05). Birth weight of the boys (3548±539g) was statistically higher than girls (3307±405 g) (p=0.028). There was a positive correlation between birth weight and right (r=0.38, p=0.000) and left kidney volumes (r=0.44, p=0.000).Conclusion: Our findings showed that measured blood urea nitrogen and creatinine levels changed in accordance with postnatal days and there was a positive correlation between kidney volume and birth weight of newborns. We concluded that these findings are important for evaluation of acute kidney injury and for screening of for urinary tract anomalies in neonates
Highlights
Acute kidney injury (AKI) is characterized by the abrupt inability of the kidneys to adequately excrete waste products and regulate fluid and electrolyte homeostasis appropriately
Serum blood urea nitrogen and creatinine concentrations have reached to the highest level at the first day of life and have returned to cord level at the third day of life
Our findings showed that measured blood urea nitrogen and creatinine levels changed in accordance with postnatal days and there was a positive correlation between kidney volume and birth weight of newborns
Summary
Acute kidney injury (AKI) is characterized by the abrupt inability of the kidneys to adequately excrete waste products and regulate fluid and electrolyte homeostasis appropriately. Developmental immaturity that limits the function of the immature kidney, hemodynamic changes like hypotension and hypoxia at birth and in the early neonatal period, an increased risk of hypovolemia due to large insensible water losses during the first days of life make newborns, especially preterms, more susceptible to renal failure. Diagnosis of neonatal renal pathology is extremely important for newborns to prevent or delay kidney injury. Knowledge of reference ranges for normal serum BUN, Cr concentration and normal renal parameters determined with USG is essential for the accurate evaluation of renal diseases or anomalies. This study was undertaken to determine ranges of ultrasonographic measurement of kidneys and both of normal serum BUN, Cr reference ranges in healthy term newborns on cord blood and 1st, 3rd, 7th, 10th, 14th, 28th days of life
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