Renal follow-up in pediatrician practice after discharge from neonatology units: about a survey
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ORIGINAL ARTICLE
Renal follow-up in pediatrician practice after discharge from neonatology units: about a survey Aurélie De Mul 1 & Paloma Parvex 1 & Alexandra Wilhelm-Bals 1 & Marie Saint-Faust 2 Received: 15 December 2019 / Revised: 11 March 2020 / Accepted: 15 April 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract There is growing evidences of long-term renal and cardiovascular consequences of prematurity, intra-uterine growth restriction, and neonatal acute kidney injury (AKI). We performed an online survey to describe current pediatric management in this population, sent to 148 ambulatory pediatricians in Geneva. Among the 40% of pediatricians who completed the survey, 43% modify their blood pressure measurement practice in case of neonatal acute kidney injury, 24% and 19% in a context of prematurity or intra-uterine growth restriction, respectively. Twenty-five percent provide information about cardiovascular risk factors or catch up growth. In case of prematurity or intra-uterine growth restriction, renal tests (ultrasound, serum creatinine, micro albuminuria) or referral to nephrologist were realized by less than 5% of the pediatricians. For neonatal acute kidney injury, renal tests, and referral to specialists are performed by 30 and 60% of pediatricians, respectively. When prematurity or intrauterine growth restriction was associated with abnormal blood pressure or abnormal renal tests, the referral to the specialist reached 80%. Conclusion: Ambulatory renal and cardio-vascular follow-up in case of neonatal medical history can be enhanced, with necessity to raise awareness and to edict guidelines available to pediatricians. What is Known: • There is a compelling evidence of long-term renal and cardiovascular consequences of prematurity and low birth weight. • Specific cardiovascular and renal follow-up guidelines, coming from professional organizations, are currently not available for these patients. What is New: • Pediatricians in ambulatory setting do not adapt their renal and cardiovascular follow-up in case of neonatal medical history. • There is a necessity to raise awareness about these long-term consequences among pediatricians and to edict guidelines available to them.
Keywords Infant, premature . Infant, low birth weight . Acute kidney injury . Blood pressure Abbreviations AKI Acute kidney injury BP Blood pressure
CKD IUGR LBW
Chronic kidney disease Intra-uterine growth restriction Low Birth weight
Communicated by Mario Bianchetti * Aurélie De Mul [email protected] Paloma Parvex [email protected] Alexandra Wilhelm-Bals [email protected] 1
Pediatric Nephrology Unit, Geneva University Hospital, Rue Willy-Donzé 6, 1205 Geneva, Switzerland
2
Neonatal Intensive Care Unit, Geneva University Hospital, Rue Willy-Donzé 6, 1205 Geneva, Switzerland
Introduction Ten percent of the population in industrial countries is born preterm. Due to remarkable advances in neonatal intensive care, most of them survive into adulthood without major morbidity.
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