Abstract

Abstract: Introduction: Hemodynamically significant patent ductus arteriosus (HSPDA) lowers the renal circulation because of the "ductal stealing phenomenon," which can change the renal blood flow.
 The aim: To study the state of blood flow in the main renal artery and interlobar renal artery in premature infants with HSPDA. 
 Materials and methods: 74 preterm newborns (gestational age 29-36 weeks) were divided into three groups: І - 40 children with HSPDA, ІІ - 17 children with patent ductus arteriosus (PDA) without hemodynamic disorders, ІІІ - 17 children with closed ductus arteriosus. Color ultrasound Doppler scan of the vascular bed of the kidneys was performed using a microconvex sensor with a frequency of 5-8 MHz ("TOSHIBA" Nemso XG model SSA-580A (Japan) from the main renal artery to the interlobar renal arteries of the right kidney. The following parameters of renal blood flow were studied: peak systolic velocity (PSV), end-diastolic velocity (EDV), resistance index (RI). 
 Results: Peak systolic velocity (PSV) in the main renal artery and interlobar renal arteries did not differ significantly between groups. On the first, third, and tenth days of life, there was a significant decrease in the EDV of blood flow and increased RI in the main renal artery. The EDV of blood flow and RI in the interlobar renal artery on the first day of life did not differ depending on PDA's presence and its hemodynamic significance. On the third and tenth days of life and in the interlobar renal artery, a significant decrease in EDV of blood flow and increased RI were noted. These renal blood flow characteristics were closely related to the size of the PDA on the first day of life.
 Conclusion: A feature of renal hemodynamics in HSPDA in premature infants is a decrease in the EDV of blood flow in the main renal artery and interlobar renal artery, as well as an increase in the RI of these vessels, directly correlating with the size of the PDA in the first day of life. During the first ten days of life, dynamic control revealed a slowed process of restoration of renal blood flow in babies with HSPDA, despite the PDA's closure.

Highlights

  • Significant patent ductus arteriosus (HSPDA) lowers the renal circulation because of the "ductal stealing phenomenon," which can change the renal blood flow

  • The increase in stroke volume in premature infants with Hemodynamically significant patent ductus arteriosus (HSPDA) explains the data obtained in our study: the Peak systolic velocity (PSV) value of blood flow in the main renal artery and interlobar renal artery did not differ depending on the presence of HSPDA

  • CONCLUSIONS a feature of renal hemodynamics in HSPDA in premature infants is a decrease in the End diastolic velocity (EDV) value of blood flow in the main renal artery and interlobar renal artery and an increase in the Resistance index (RI) of these vessels

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Summary

Introduction

Significant patent ductus arteriosus (HSPDA) lowers the renal circulation because of the "ductal stealing phenomenon," which can change the renal blood flow. Third, and tenth days of life, there was a significant decrease in the EDV of blood flow and increased RI in the main renal artery. On the third and tenth days of life and in the interlobar renal artery, a significant decrease in EDV of blood flow and increased RI were noted. Conclusion: A feature of renal hemodynamics in HSPDA in premature infants is a decrease in the EDV of blood flow in the main renal artery and interlobar renal artery, as well as an increase in the RI of these vessels, directly correlating with the size of the PDA in the first day of life. This creates pathogenetic prerequisites for developing such complications of HSPDA, such as acute kidney injury and necrotizing enterocolitis [6]

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