Association of Acute Kidney Injury and Intraventricular Hemorrhage in Preterm Infants

Öz

Objective: Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) is seen in 40% of preterm infants. There are various studies suggesting that acute kidney injury (AKI), increases the frequency of GMH-IVH. We aimed to investigate the effects of AKI on the development of GMH-IVH in preterm infants. Methods : 158 infants with a gestational age of less than 32 weeks and/or a birth weight of less than 1500 grams are examined. Demographic, clinical, imaging and laboratory data of the cases were recorded. Results: GMH-IVH was detected in 18.4% (29/158) of the patients whereas AKI was detected in 11.4% (18/158) of the patients in the first seven days of life. The development of AKI in the first seven days was significantly higher in the group with GMH-IVH than in the group without GMH-IVH. GMH-IVH was significantly higher in the group with AKI than in the group without AKI. The GMH-IVH stage of the patients with AKI was also significantly higher than the group without AKI. Multivariate regression analysis showed that AKI was an independent risk factor for the development of GMH-IVH in the first seven days of life. Conclusion: Although it is difficult to establish a direct cause and effect relationship between AKI and GMH-IVH, there is a strong association between acute kidney injury and GMH-IVH.

Anahtar Kelimeler

• Germinal matrix hemorrhage
• intraventricular hemorrhage
• acute kidney injury
• prematurity

PRETERM BEBEKLERDE AKUT BÖBREK HASARI İLE İNTRAVENTRİKÜLER KANAMA İLİŞKİSİ

Öz

Amaç: Germinal matriks kanaması-intraventriküler kanamalar (GMK-İVK) preterm bebeklerin %40’ında görülür. Akut böbrek hasarının (ABH), GMK-İVK’yı artırdığına işaret eden çeşitli çalışmalar mevcuttur. Bu çalışmada preterm bebeklerde görülen ABH’nın GMK-İVK gelişimi üzerindeki etkisi araştırıldı. Yöntemler: 32 hafta ve altı ile 1500 gram ve altında doğum ağırlığı olan 158 bebek incelendi. Demografik, klinik, görüntüleme ve laboratuvar verileri kayıt edildi. Bulgular: Doğumdan sonraki ilk 7 günde hastaların %18,4’ünde (29/158) GMK-İVK tespit edilirken %11,4’ünde (18/158) ABH gelişmişti. GMK-İVK olan grupta ABH GMK-İVK olmayan gruba göre anlamlı olarak daha yüksekti. ABH olan grupta da GMK-İVK ABH olmayan gruba göre anlamlı olarak daha yüksekti. ABH olan grupta GMK-İVK evresi, olmayan gruba kıyasla daha yüksekti. Çoklu regresyon analizi, ilk 7 günde GMK-İVK gelişimi için ABH’nın bağımsız bir risk faktörü olduğunu gösterdi. Sonuç: ABH ile GMK-İVK arasında doğrudan bir nedensellik ilişkisi kurmak zor olsa da ABH ve GMK-İVK arasında anlamlı bir birliktelik bulunduğu gösterilmiştir.

Anahtar Kelimeler

• Germinal matriks kanaması
• intraventriküler kanama
• akut böbrek hasarı
• prematüre

Kaynakça

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