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Background <p>Kidneys in preterm infants are exposed to various exogenous factors that may affect their maturation and development. Hence, they are at a higher risk of developing nephrocalcinosis (NC). We aimed to evaluate the incidence, risk factors, and short-term outcomes of NC in preterm neonates admitted to a tertiary-care neonatal unit.</p> Methods <p>This prospective observational study included preterm infants born at &lt; 33&#xa0;weeks gestation. Infants with congenital anomalies of the kidney and urinary tract (CAKUT) or major malformations were excluded. Ultrasound scans were performed at 3–6&#xa0;weeks of postnatal age to screen for NC using a modified grading system. Clinical data, including demographics, respiratory support, medication exposure, nutrition, and biochemical markers, were collected. Infants with NC were followed up at 3 and 6&#xa0;months of corrected age to assess the resolution of NC and kidney function.</p> Results <p>Among the 152 enrolled neonates, 23 (15.1%) had NC. Respiratory distress syndrome (RDS) (adjusted odds ratio [aOR] 3.6; 95% CI: 1.1–12.3; <i>p</i> = 0.04) and total parenteral nutrition (TPN) (aOR-4.5; 95% CI: 1.2–16.8; <i>p</i> = 0.03) were independently associated with NC. At 3&#xa0;months, 17 of the 23 infants were re-evaluated, and NC resolved in 13 (76.5%). By 6–8&#xa0;months, all but one infant showed resolution. All the infants had normal kidney function at the last follow-up.</p> Conclusion <p>Nephrocalcinosis occurred in 15% of preterm neonates and was significantly associated with RDS and TPN use. Most cases resolved spontaneously without adverse outcomes. These findings support targeted NC screening in high-risk neonates.</p> Graphical abstract <p></p>

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Incidence, risk factors, and outcomes of nephrocalcinosis in preterm infants: a prospective cohort study

  • 期刊论文

  • 发表日期：

    2025年7月14日

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  • Mithun Krishna,
  • Jitendra Meena,
  • Anmol Bhatia,
  • Arushi Yadav,
  • Jogender Kumar,
  • Kanya Mukhopadhyay,
  • Praveen Kumar

摘要

Background

Kidneys in preterm infants are exposed to various exogenous factors that may affect their maturation and development. Hence, they are at a higher risk of developing nephrocalcinosis (NC). We aimed to evaluate the incidence, risk factors, and short-term outcomes of NC in preterm neonates admitted to a tertiary-care neonatal unit.

Methods

This prospective observational study included preterm infants born at < 33 weeks gestation. Infants with congenital anomalies of the kidney and urinary tract (CAKUT) or major malformations were excluded. Ultrasound scans were performed at 3–6 weeks of postnatal age to screen for NC using a modified grading system. Clinical data, including demographics, respiratory support, medication exposure, nutrition, and biochemical markers, were collected. Infants with NC were followed up at 3 and 6 months of corrected age to assess the resolution of NC and kidney function.

Results

Among the 152 enrolled neonates, 23 (15.1%) had NC. Respiratory distress syndrome (RDS) (adjusted odds ratio [aOR] 3.6; 95% CI: 1.1–12.3; p = 0.04) and total parenteral nutrition (TPN) (aOR-4.5; 95% CI: 1.2–16.8; p = 0.03) were independently associated with NC. At 3 months, 17 of the 23 infants were re-evaluated, and NC resolved in 13 (76.5%). By 6–8 months, all but one infant showed resolution. All the infants had normal kidney function at the last follow-up.

Conclusion

Nephrocalcinosis occurred in 15% of preterm neonates and was significantly associated with RDS and TPN use. Most cases resolved spontaneously without adverse outcomes. These findings support targeted NC screening in high-risk neonates.

Graphical abstract