Prognostic factors in neonatal acute renal failure

Journal Article · Wed Aug 01 04:00:00 EDT 1984 · Pediatrics; (United States)

OSTI ID:6756914

Chevalier, R L; Campbell, F; Brenbridge, A N

Sixteen infants, 2 to 35 days of age, had acute renal failure, a diagnosis based on serum creatinine concentrations greater than 1.5 mg/dL for at least 24 hours. Eight infants were oliguric (urine flow less than 1.0 mL/kg/h) whereas the remainder were nonoliguric. To determine clinical parameters useful in prognosis, urine flow rate, duration of anuria, peak serum creatinine, urea (BUN) concentration, and nuclide uptake by scintigraphy were correlated with recovery. Nine infants had acute renal failure secondary to perinatal asphyxia, three had acute renal failure as a result of congenital cardiovascular disease, and four had major renal anomalies. Four oliguric patients died: three of renal failure and one of heart failure. All nonoliguric infants survived with mean follow-up serum creatinine concentration of 0.8 +/- 0.5 (SD) mg/dL whereas that of oliguric survivors was 0.6 +/- 0.3 mg/dL. Peak serum creatinine concentration did not differ between those patients who were dying and those recovering. All infants who were dying remained anuric at least four days and revealed no renal uptake of nuclide. Eleven survivors were anuric three days or less, and renal perfusion was detectable by scintigraphy in each case. However, the remaining survivor (with bilateral renal vein thrombosis) recovered after 15 days of anuria despite nonvisualization of kidneys by scintigraphy. In neonates with ischemic acute renal failure, lack of oliguria and the presence of identifiable renal uptake of nuclide suggest a favorable prognosis.

• Research Organization: Department of Pediatrics, University of Virginia School of Medicine, Charlottesville
• OSTI ID: 6756914
• Journal Information: Pediatrics; (United States), Journal Name: Pediatrics; (United States) Vol. 74:2; ISSN PEDIA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
AGE GROUPS
BODY
CARDIOVASCULAR DISEASES
CHILDREN
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
INFANTS
ISCHEMIA
KIDNEYS
MORTALITY
ORGANS
RADIOISOTOPE SCANNING
SCINTISCANNING
THROMBOSIS
UROGENITAL SYSTEM DISEASES
VASCULAR DISEASES