Risk Factors for Nephrocalcinosis in Very Low Birth Weight Infants

Abstract

Objective: The objective was to identify risk factors for nephrocalcinosis in very low birth weight (VLBW) infants. Methods: Prospective study has done between 2014 and 2017. The study included 81 VLBW infants in the neonatal intensive care unit (NICU). Renal ultrasonography was performed at four weeks and 3 months. Baseline characteristics, complications and medication during NICU admission were col lected. 25(OH)vitamin D, calcium, phosphorous, alkaline phosphatase, urine calcium to creatinine ratio were serially measured. Results: The incidence of nephrocalcinosis was 16.9%. On univariate analysis, gestational age, lower birth weight, maternal pregnancyinduced hypertension, neonatal sepsis, and frequency of vanco mycin and caffeine citrate treatment were significantly associated with nephrocalcinosis. In addition, preterm infants with nephrocalcinosis had lower cord blood 25(OH)vitamin D and serum calcium levels and higher serum alkaline phosphatase levels at 2 weeks of life. Multivariate analysis showed that gestational age (P=0.042), birth weight (P=0.019), sepsis (P=0.046), small for gestational age (P=0.015), and maternal pregnancyinduced hypertension (P=0.024) were significant risk factors for nephrocalcinosis. Conclusion:This study suggests that neonatal sepsis and maternal pregnancyinduced hypertension, in addition to gestational age and birth weight are important perinatal risk factors for nephrocalcinosis.