PT  - JOURNAL ARTICLE
AU  - Kari, Jameela A.
AU  - Sharief, Sara N.
AU  - El-Desoky, Sherif M.
AU  - Alhasan, Khalid A.
AU  - Albanna, Amr S.
TI  - Etiology, ethics, and outcomes of chronic kidney disease in neonates
AID  - 10.15537/smj.2018.4.21712
DP  - 2018 Apr 01
TA  - Saudi Medical Journal
PG  - 361--367
VI  - 39
IP  - 4
4099  - http://smj.org.sa/content/39/4/361.short
4100  - http://smj.org.sa/content/39/4/361.full
SO  - Saudi Med J2018 Apr 01; 39
AB  - Objectives: To report the epidemiology of chronic kidney disease (CKD) in neonates at a single tertiary center and the outcomes of renal replacement therapy (RRT) in these patients and discuss ethical considerations regarding RRT in this population.Methods: In this retrospective study, we reviewed clinical data from all neonates with evidence of CKD who were followed up at King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between 2005 and 2015. Follow-up serum creatinine levels were recorded every 6 months.Results: A total of 181 neonates presented with CKD. Their mean age at the time of presentation was 11.1 days (95% confidence interval [CI]: 9.5-12.8) and the mean creatinine level was 106.5 µmol/ (95% CI: 91.3-121.7). Congenital anomalies of the kidneys and urinary tract (CAKUT) were the underlying causes of CKD in 84.5% of the neonates. Mortality was high, particularly in the first 6 months (10%), and reached 16% by 4 years of follow-up. At the time of the last follow-up, 42 (41%) neonates had hypertension and 27 (26.5%) had significant proteinuria. Five patients received dialysis in the neonatal period and another 6 were commenced on dialysis later.Conclusion: Congenital anomalies of the kidneys and urinary tract is the most common etiology in neonates with CKD. Chronic kidney disease in neonates is associated with high morbidity and mortality rates.