Factores determinantes de la elevación de la uremia en los primeros días de vida en recién nacidos con menos de 30 semanas de gestación
- G. Bustos Lozano
- C. Orbea Gallardo
- S. Fernández de Miguel
- M.aC. Muñoz Labián
- López Maestro, María
- M. Moral Pumarega
ISSN: 1695-4033, 1696-4608
Ano de publicación: 2003
Volume: 59
Número: 6
Páxinas: 559-564
Tipo: Artigo
Outras publicacións en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Resumo
Objective To identify the determinants associated with uremia elevation in the first days of life in extremely premature infants. Methods We performed a prospective cohort study in a cohort of neonates born at less than 30 weeks of gestation. Results Forty-eight preterm infants were included, of which 10 died. The mean fluid administration was 55, 72, 88 and 124 mL/kg on the first, second, third and seventh days of life. Amino acid doses were low in the first two days of life and were unrelated to uremia elevation. Thirty-one percent of the infants presented hypernatremia. Uremia was measured in 31 infants between the fifth and tenth days of life and 12 infants (38.7 %) had uremia values of 100 mg/dL or higher, without creatinine elevation. All of these infants were born at less than 27 weeks of gestation, weighed less than 850 grams at birth, and showed greater weight loss (19.2% vs. 13.8%; p = 0.037) and higher natremia (150.2 mEq/L vs. 146.6 mEq/L; p = 0.023). The use of furosemide increased the risk of elevated uremia (relative risk: 2.54; 95 % confidence interval: 1.05 – 6.14). Conclusions Total uremia of 100 mg/dL or higher was associated with dehydration, greater weight loss, higher natremia, furosemide use, lower gestational age, and lower birth weight.