Creatinine Trends and Patterns in Neonates Undergoing Whole Body Hypothermia: A Systematic Review

Children

Anne Smits¹  Noor Borloo¹  Karel Allegaert¹  Pieter Annaert²  Liesbeth Thewissen³ 

[1] Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium;Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium;Neonatal Intensive Care Unit, UZ Leuven, Herestraat 49, 3000 Leuven, Belgium;

关键词: creatinine;    cystatin C;    asphyxia;    whole body hypothermia;    acute kidney injury;    renal clearance;   

DOI  :  10.3390/children8060475

来源: DOAJ

【 摘 要 】

Many neonates undergoing whole body hypothermia (WBH) following moderate to severe perinatal asphyxia may also suffer from renal impairment. While recent data suggest WBH-related reno-protection, differences in serum creatinine (Scr) patterns to reference patterns were not yet reported. We therefore aimed to document Scr trends and patterns in asphyxiated neonates undergoing WBH and compared these to centiles from a reference Scr data set of non-asphyxiated (near)term neonates. Using a systematic review strategy, reports on Scr trends (mean ± SD, median or interquartile range) were collected (day 1–7) in WBH cohorts and compared to centiles of an earlier reported reference cohort of non-asphyxia cases. Based on 13 papers on asphyxia + WBH cases, a pattern of postnatal Scr trends in asphyxia + WBH cases was constructed. Compared to the reference 50th centile Scr values, mean or median Scr values at birth and up to 48 h were higher in asphyxia + WBH cases with a subsequent uncertain declining trend towards, at best, high or high–normal creatinine values afterwards. Such patterns are valuable for anticipating average changes in renal drug clearance but do not yet cover the relevant inter-patient variability observed in WBH cases, as this needs pooling of individual Screa profiles, preferably beyond the first week of life.

【 授权许可】

Unknown