Can peak creatininemia be used as risk indicator for retinopathy of prematurity in ELBW infants?

Abstract

Retinopathy of prematurity (ROP) is a multifactorial disease with risk factors related to immaturity (gestational age, birth weight) and disease severity. We aimed to validate the use of peak creatinaemia as risk factor for prethreshold ROP in a recently treated cohort following its association in two historical cohort studies. Data on clinical characteristics and peak creatinine were collected in ELBW (extreme low birth weight, < 1000 g) infants admitted between 2007–2011. Data in cases who developed prethreshold ROP were compared to controls (Mann Whitney U, Chi square) and significant risk factors were entered in a logistic regression model. Based on 123 patients of whom 24 developed threshold ROP, gestational age, birth weight and indicators of respiratory disease were significant risk factors, while peak creatinine was not longer a significant risk factor for prethreshold ROP. Immaturity became the dominant risk factor. Creatinine is no longer a biomarker to develop prethreshold ROP in our unit, likely due to the overall decreased incidence of ROP in our unit. This illustrates the need to validate biomarkers (e.g. creatinemia) in consecutive cohorts within the same unit and in other units before such biomarkers can be considered for secondary ROP prevention strategies.

Keywords

Retinopathy of prematurity - creatinine - biomarker - risk factors - ELBW infants