RT Journal Article
SR Electronic
T1 Etiology, ethics, and outcomes of chronic kidney disease in neonates
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 361
OP 367
DO 10.15537/smj.2018.4.21712
VO 39
IS 4
A1 Jameela A. Kari
A1 Sara N. Sharief
A1 Sherif M. El-Desoky
A1 Khalid A. Alhasan
A1 Amr S. Albanna
YR 2018
UL http://smj.org.sa/content/39/4/361.abstract
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.