窒息相关新生儿急性肾损伤危险因素及临床特征分析OACSTPCD

Objective To investigate the risk factors and clinical characteristics of asphyxia-re-lated acute kidney injury(AKI)in neonates.Methods A retrospective analysis was conducted on the clinical data of neonates with asphyxia-related AKI(AKI group,n=100)and asphyxia withont AKI neonates(control group,n=228)admitted to the neonatal intensive care unit(NICU)of the First Affiliated Hospital of Nanjing Medical University from January 2020 to December 2023.Labora-tory indicators and clinical data from both groups were collected to analyze the risk factors and clinical characteristics of asphyxia-related AKI in neonates.Results Statistically significant differences were observed in levels of lactate,base excess(BE),serum potassium,serum creatinine,and urea nitro-gen between the AKI and control groups(P＜0.05).Multivariate Logistic regression analysis re-vealed that low 5-minute Apgar score,high lactate level,and hyperglycemia were independent risk factors for asphyxia-related AKI in neonates.The areas under the curve(AUCs)for the 5-minute Ap-gar score,lactate,and blood glucose in predicting AKI were 0.825(95％CI,0.767 to 0.882),0.968(95％CI,0.942 to 0.993),and 0.845(95％CI,0.795 to 0.894),respectively.The inci-dence of maternal hypertension during pregnancy also showed a significant difference between the two groups(P＜0.05).Significant differences were also noted in 1-minute and 5-minute Apgar scores,as well as the incidence of intrauterine distress between the AKI and control groups(P＜0.05).Fur-thermore,the AKI group exhibited statistically significant differences in respiratory distress syndrome(RDS),respiratory failure,necrotizing enterocolitis(NEC),severe intracranial hemorrhage,pulmonary hemorrhage,use of diuretics,and blood purification etc.compared to the control group(P＜0.05).There were 24 deaths in the AKI group,with 16 cases in AKI stage 3 and 8 cases in AKI stage 2,while only 3 deaths occurred in the control group.The difference in mortality rate between the two groups was statistically significant(P＜0.05).Conclusion Low 5-minute Apgar score,high lactate levels,and hyperglycemia are independent risk factors for AKI in neonates.Neonates with AKI are prone to developing multi-organ dysfunction,and asphyxia-related AKI can increase mortality rates.Therefore,comprehensive prevention and treatment measures are crucial.