Risk Factors and Outcome of Nephrocalcinosis in Very Low Birth Weight Infants

Abstract

� Original Article � furosemide therapy in 1982. Among different studies, the prevalence of NC ranged from 7 to 41% in very low birth weight (VLBW) infants with a gestational age less than 32 weeks. [3][4][5][6][7][8][9] The etiology of NC is multifactorial including low gestational age and birth weight. Male sex, family history, white race, mechanical ventilation, oxygen therapy, bronchopulmonary dysplasia (BPD), the use of furosemide, methylxanthine, dexamethasone, gentamicin, total parenteral nutrition (TPN), acidosis, hypercalcemia, hypophosphatemia, hypercalciuria, hyperoxaluria, hyperuricuria, and hypocitruria are associated with development of NC. Purpose: The aim of this study was to determine the incidence, risk factors, and long-term outcome of nephrocalcinosis in very low birth weight (VLBW) infants. Methods: A retrospective chart review was performed in VLBW infants between 2006 and 2012 in the neonatal intensive care unit. Results:The incidence of nephrocalcinosis in VLBW infants was 10.2%. By univariate analysis, oligohydramnios and use of antenatal steroids were more frequent in the nephrocalcinosis group. In the nephrocalcinosis group, the gestational age and birth weight were lower and there were more number of female infants. Also, the initial blood pH, the lowest systolic blood pressure, and urine output on the first day of life were lower and bronchopulmonary dysplasia, sepsis, and urinary tract infection were more prevalent in the nephrocalcinosis group. The use of dexamethasone or ibuprofen and the lowest levels of phosphorus, protein and albumin were significantly lower in the nephrocalcinosis group. By binary logistic regression analysis, the use of antenatal steroids, female sex, 5-minute Apgar score, duration of oxygen therapy and total parenteral nutrition, and the lowest albumin level were found to be significant risk factors for nephrocalcinosis. Overall, the resolution rate was 64.1% and 88.6% within 12 months and 18 months, respectively. Conclusions:The incidence of nephrocalcinosis in VLBW infants showed increasing trend. The risk factors of nephrocalcinosis were parameters for sick VLBW infants. Although the prognosis of nephrocalcinosis was relatively good, we should pay close attention to the development of complication.

Acute kidney injury in an extremely low birth weight infant with nephrolithiasis: a case report

“…Mostly, nephrocalcinosis disappears by itself but in individual cases it manifests by the formation of stones that complicate the course of the disease and may have long-term consequences. A clinical case of one neonate, born at the 27th week of gestation, with the birth weight of 850 grams, was described (7). She was two months old when her diagnosis of nephrocalcinosis with multiple stones in both kidneys was made.…”

“…Kidney stones in preterm infants cause recurrent urinary tract infections, microhaematuria, (6) and sometimes urinary tract obstruction requiring surgical intervention (6, 11). It can progress to chronic kidney disease (7).…”