Acute renal failure SNAPPE and mortality

Background: The aim of the present study was to determine, using the score for neonatal acute physiology and perinatal extension II (SNAPPE‐II), whether there is an association with acute renal failure (ARF) and whether it is possible to identify newborns at risk for ARF prior to a rise in creatini...

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Published in:	Pediatrics international Vol. 53; no. 4; pp. 483 - 488
Main Authors:	Türker, Gülcan, Özsoy, Gamze, Günlemez, Ayla, Gökalp, Ayşe S., Arisoy, Ayşe E., Bircan, Zelal
Format:	Journal Article
Language:	English
Published:	Melbourne, Australia Blackwell Publishing Asia 01-08-2011 Blackwell Publishing Ltd
Subjects:	Acute Kidney Injury - blood Acute Kidney Injury - diagnosis Acute Kidney Injury - mortality acute renal failure Coagulation Creatinine - blood Ductus Arteriosus, Patent - complications Female Humans Infant, Newborn Infants Kidney diseases Logistic Models Male Mortality Neonates Newborn babies newborn mortality Physiology postnatal risk factor prematurity Prognosis Retrospective Studies Risk Factors ROC Curve scores for neonatal acute physiology and perinatal extension II Severity of Illness Index
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Summary:	Background: The aim of the present study was to determine, using the score for neonatal acute physiology and perinatal extension II (SNAPPE‐II), whether there is an association with acute renal failure (ARF) and whether it is possible to identify newborns at risk for ARF prior to a rise in creatinine in newborns. Methods: Information on postnatal risk factors and SNAPPE‐II on the first day of life (non‐ARF group, n= 475; ARF group, n= 78) were collected. Renal failure was defined as serum creatinine level >1 mg/dL and >1.3 mg/dL (for ≥33 weeks and <33 weeks, respectively) after 48 h of life. Results: In newborns with ARF (n= 78), the median (range) of SNAPPE‐II and mortality rate were significantly higher than those of the control group. Patent ductus arteriosus (PDA), disseminated intravascular coagulation (DIC), SNAPPE‐II, and resuscitation were identified as independent predictors of ARF in infants on forward stepwise logistic regression. Sepsis, respiratory distress syndrome, ARF, DIC, and SNAPPE‐II were identified as independent predictors of mortality in infants on the same analysis. Conclusions: SNAPPE‐II on the first day of life was significantly higher among babies with ARF, suggesting a positive association between higher scores and the development of ARF and mortality, but based on receiver operating characteristic curve results, SNAPPE‐II at admission did not enhance the assessment of risk for ARF prior to a rise in creatinine.
Bibliography:	ArticleID:PED3377 istex:5CCD5E54F8C160B38D69192D0BB506A1D687634F ark:/67375/WNG-9HHRHW6C-W ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	1328-8067 1442-200X
DOI:	10.1111/j.1442-200X.2011.03377.x