Samara state medical hospital named by V.D. Seredavin, Russian Federation
Stepan Aborin has a scientific interest in neonatal nephrology, devotes special attention to the problem of neonatal acute kidney injury, as well as the use of methods of renal replacement therapy in the neonatal period. In his work is based on the principles of evidence-based medicine. He is the head of the neonatal intensive care unit, engaged in teaching. He has a scientific degree of candidate of medical sciences.
Statement of the problem: Acute kidney injury (AKI) in the neonatal period is a very urgent problem worldwide. According to our data, the incidence of AKI among patients in neonatal intensive care units (NICU) is 23%. At the same time, the disease has a very high mortality rate, an among AKI survivors there is a high risk of developing chronic kidney disease. Treatment of AKI in newborns and premature infants is a complex task. The basis of treatment is the correct management of intravenous infusions, strict accounting of hydro balance, optimal nutrition support and renal replacement therapy. Currently, the use of dialysis in newborns remains a serious problem. The methods of choice are peritoneal dialysis and continuous renal replacement therapy. A particular problem is the management of AKI in premature infants with very low and extremely low birth weight (VLBW, ELBW). The purpose of this study: to describe the experience of treatment of critically ill neonates with AKI, to identify the main problems of management AKI. Methodology and theoretical orientation: We conducted a study among premature infants with VLBW and ELBW is entering the NICU. The reasons of hospitalization were violations of vital functions. We assessed the anamnesis, clinical and laboratory data, the dynamics of renal excretory function, as well as the study of novel urinary biomarker NGAL. Results: According to our study, the incidence of AKI among premature infants with VLBW and ELBW is 42?3 with 77?3% occurring at the 1 stage of AKI. The presence of AKI in premature neonate is significantly associated with respiratory dysfunction, hemodynamic instability and cerebral insufficiency. We have identified a number of risk factors, the presence of which allows predicting the development of AKI. We have formulated recommendations for early detection and possible non-dialysis prevention.