Infant Journal
for neonatal and paediatric healthcare professionals

Renal profiles in extreme prematurity: a three-year review

In this study we review the serum urea and serum creatinine of 74 premature infants born under 27 weeks’ gestation over a three-year period. We follow the progression of their renal profiles from birth until discharge. We assess the impact of gestation, birth weight, gender and antenatal medications on these renal biomarkers.

Faezeh Sakhinia1
Paediatric ST7 Renal GRID Trainee

Chris Worth2,3
Clinical Research Fellow in Congenital Hyperinsulinism and Doctoral Researcher in Computer Science

Archana Mishra4
Neonatal Consultant

1Department of Paediatric Nephrology, Royal Manchester Children’s Hospital
2Department of Paediatric Endocrinology, Royal Manchester Children’s Hospital
3Department of Computer Science, University of Manchester
4Department of Neonatology, Royal Bolton Hospital

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nephrology; renal; urea; creatinine
Key points
  1. With increasing gestation, higher values of serum urea and creatinine are seen at birth, followed by an inverse correlation from day two of life.
  2. Since the introduction of caffeine citrate and better awareness of neonatal acute kidney injury, we demonstrate an improvement in renal profiles of extremely premature infants.
  3. We provide the first detailed description on the renal biomarkers of infants born under 24 weeks’ gestation.

Also published in Infant:

A neonate with congenital nephrotic syndrome
A male infant who was born in poor condition exhibited a persistently raised creatinine level over the first 14 days of life but showed no neurological signs of a significant hypoxic insult. A diagnosis of Finnish-type congenital nephrotic syndrome was eventually made by genetic testing. For neonates presenting with unusual or rare underlying pathologies there may be a period of time in which their signs and symptoms are attributed to a more common pathology. This case report illustrates that alternative more unusual diagnoses must be considered and explored when symptoms and results do not follow an expected course.