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Table 2 Proposed practice guidelines for optimization of renal conservation efforts

From: Renal consequences of preterm birth

 

During NICU

Health Maintenance for survivors of prematurity

Monitoring renal function

Volume status, weight, ins and out

Vital signs

Serum electrolytes, crea, and FeNa:

Supplementation if prudentMaintain target serum electrolyte values

Awareness of prematurity-related increased risk throughout lifespan [7]

Assess serially volume status, weight, diuresis

Vital signs (esp BP)

Tubular parameters (FeNa/β2-M)

Glomerular parameters (albumin/creatinine)

Medications

Drug levels/pharmacist input=>

Dosing adjustment

Taking renal maturation into account

Daily evaluation of medications

Awareness of baseline renal function appropriate choice and adjustment of potential medications

Arterial hypertension

Blood pressure monitoring daily as needed in the acute/sick phase or if abnormal

Rule out coarctation aortae

Consider renal vascular Doppler

Blood pressure measurement

With every health maintenance visit

Target age-appropriate values [74]

Counseling about salt sensitivity

Nephrocalcinosis

Renal ultrasound before discharge

Follow-up ultrasound for resolution

If progression consider urine Ca/creatinine