Acute renal failure SNAPPE and mortality

Background: The aim of the present study was to determine, using the score for neonatal acute physiology and perinatal extension II (SNAPPE‐II), whether there is an association with acute renal failure (ARF) and whether it is possible to identify newborns at risk for ARF prior to a rise in creatinine in newborns. Methods: Information on postnatal risk factors and SNAPPE‐II on the first day of life (non‐ARF group, n= 475; ARF group, n= 78) were collected. Renal failure was defined as serum creatinine level >1 mg/dL and >1.3 mg/dL (for ≥33 weeks and <33 weeks, respectively) after 48 h of life. Results: In newborns with ARF (n= 78), the median (range) of SNAPPE‐II and mortality rate were significantly higher than those of the control group. Patent ductus arteriosus (PDA), disseminated intravascular coagulation (DIC), SNAPPE‐II, and resuscitation were identified as independent predictors of ARF in infants on forward stepwise logistic regression. Sepsis, respiratory distress syndrome, ARF, DIC, and SNAPPE‐II were identified as independent predictors of mortality in infants on the same analysis. Conclusions: SNAPPE‐II on the first day of life was significantly higher among babies with ARF, suggesting a positive association between higher scores and the development of ARF and mortality, but based on receiver operating characteristic curve results, SNAPPE‐II at admission did not enhance the assessment of risk for ARF prior to a rise in creatinine.