PREDICTIVE FACTORS AND CLINICAL AND PARACLINICAL FEATURES OF URINARY TRACT DYSFUNCTION IN PRETERM INFANTS

Acute kidney injury is a multifactorial clinical pathological syndrome that falls within the critical conditions of the early neonatal period and independently associates with high rates of morbidity and mortality. The frequency of acute kidney injury in critically ill preterm infants varies signifi cantly, ranging from 25 % to 77 % according to diff erent studies. Numerous scientifi c investigations describe an inversely proportional correlation between gestational age and birth weight. Of particular importance in terms of pathophysiology is the understanding of the concept of ‘functional acute kidney injury,’ clinically characterized by a reduction in glomerular fi ltration rate in the absence of markers of tubular damage. Consequently, it represents potentially reversible changes in renal function, sensitive to both the duration and depth of the alterations, which precede the development of injury.Aim of the study: To conduct an analysis of clinical characteristics, risk factors, and results of paraclinical examinationsin preterm infants with gestational ages of 25-31 and 32-33 weeks, who exhibited signs of severe functional disturbances in the urinary system during the early neonatal period as part of complex perinatal pathology.Materials and Methods: A comprehensive clinical and paraclinical examination was conducted on 93 preterm infants with severe perinatal pathology. Group I comprised 30 infants with gestational ages of 25-31 weeks, while Group II consisted of 32 infants with gestational ages of 32-33 weeks. Group III included 31 conditionally healthy preterm infants with gestational ages of 34-36 weeks. Verifi cation of the diagnosis of renal dysfunction was performed according to the recommended international classifi cation ‘Kidney Disease: Improving Global Outcomes’ with the modifi cation by J. G. Jetton and D. J. Askenazi (2015). The degree of severity of polyorgan defi ciency in perinatal pathology in newborns was assessed using the Neonatal Multiple Organ Dysfunction Score. The eff ectiveness of therapeutic interventions was evaluated using the Neonatal Therapeutic Intervention Scoring scale. The severity of the newborns’ condition during observation was assessed using the Score for Neonatal Acute Physiology scale. The research was conducted in accordance with the fundamental principles of Good Clinical Practice (GCP, 1996), the Council of Europe Convention on Human Rights and Biomedicine (April 4, 1997), the Helsinki Declaration of the Wor