Progresión de la creatinina sérica neonatal como estudio de la función renal en un centro de tercer nivel (IIIb)

  1. María Medina Muñoz 14
  2. Jair Alonso Ferrero 2
  3. Mario Cantó Cerdán 3
  4. Vanesa Matías del Pozo 2
  5. Asunción Pino Vázquez 2
  6. Pedro Juan Tárraga López 4
  1. 1 Servicio Madrileño Salud
  2. 2 Hospital Universitario de Valladolid
    info

    Hospital Universitario de Valladolid

    Valladolid, España

    ROR https://ror.org/04fffmj41

  3. 3 Hospital Vissum Alicante
  4. 4 Universidad de Castilla-La Mancha
    info

    Universidad de Castilla-La Mancha

    Ciudad Real, España

    ROR https://ror.org/05r78ng12

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Journal:
Academic Journal of Health Sciences: Medicina Balear

ISSN: 2255-0560

Year of publication: 2024

Volume: 39

Issue: 1

Pages: 149-154

Type: Article

DOI: 10.3306/AJHS.2024.39.01.149 DIALNET GOOGLE SCHOLAR lock_openIbdigital editor

Abstract

Introduction: The neonatal population is vulnerable to kidney damage, making it necessary to study kidney function in patients at risk. Serum creatinine concentration continues to be the most used marker, requiring consideration of variations related to the kidney maturation process. Aim: To describe the evolution of serum creatinine as a study of renal function in neonatal patients from birth to the performance of nutritional analysis in a tertiary center. Methods: Descriptive, retrospective study that includes patients admitted to the NICU of a tertiary hospital between January 2013 and December 2016. Analytical data related to renal function were collected in an evolutionary manner from birth to the first nutritional analysis. Four groups of patients were identified according to gestational age. For qualitative, categorical or binary variables, frequencies and percentages were used. Kruskal-Wallis analysis/Wilcoxon test was performed for repeated measurement quantitative variables. Statistical analysis was performed using the SPSS program (Version 22.0, Inc., Chicago, US). The results were considered significant with a p value <0.05. Results: During the study period, a total of 158 patients were included, 111 (70.3%) premature. Serum creatinine at birth was higher at higher gestational age (0.55±0.09mg/dL vs 0.87±0.24mg/dL,p<0.001). In premature patients, creatinine continued to increase until 24 hours of life. This increase was greater at lower gestational age. Subsequently, there was a progressive decrease in the serum creatinine value. In term patients there was a progressive decrease from birth, more striking at 72 hours of life (p<0.001). From 24 hours of life, with the exception of nutritional analysis, the serum creatinine value was higher at lower gestational age (0.81±0.22mg/dL vs 0.55±0.29mg/ dL,p<0.001). The speed of correction seems to be earlier at higher gestational age (0.70±0.19mg/dL vs 0.48±0.29mg/dL,p<0.001). Conclusions: Serum creatinine values in neonatal patients change independently of the presence of kidney damage. Not only an increase in creatinine, but also an abnormal decrease, should be taken into account as kidney involvement. It would be necessary to perform serial determinations instead of interpreting a single serum creatinine value to study neonatal renal function.

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