Renal effects of total parenteral nutrition in premature new borns

Aim: We aimed to investigate the effects of total parenteral nutrition (TPN) on the renal functions of the preterm newborns. For this purpose, we planned to measure the serum levels of cystatin C, urine levels of N-acetyl-ß-D glucosaminidase, ß 2 microglobuline and glutathione-S transferase ? in the patients having TPN and control patients and compared the renal functions of this two groups.Material and method: The study group consisted of the patients, born within the 28-34th gestational week, being followed in the prematurity intensive care unit and having TPN and enterally nourished controls. The way of birth, sex, height, weight, presence of respiratory distress syndrome, early and late neonatal sepsis, aminoglycoside treatment of the study group were evaluated. Maternal PROM (premature rupture of membrane), UTI (urinary tract infection) , preeclampsia/eclampsia and diabetes status were recorded. Patients having TPN earlier than three days of age, having TPN less than 10 days and died in the early period were excluded from the study. All of the patient and controls serum cystatine C, glucose, BUN (blood urea nitrogen), creatinine, uric acid, total protein, albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phospatase (ALP), sodium, potassium, calcium, phosphorus, urinary N-acetyl-ß-D glucosaminidase, glutathione-S transferase ?, ß 2 microglobuline, sodium, creatinine, density, pH were studied.Results: Serum cystatine C (p<0.001), urinary ß 2 microglobuline (p<0.001), NAG (p<0.001), GST ? (p<0.001) of the TPN group were significantly higher than the enterally nourished control group.Conclusions: This study showed the negative effects of the TPN on the renal functions.Keywords: Prematurity, Total parenteral nutrition, Cystatine-C, N-acetyl-ß-D glucosaminidase, Glutathione-S transferase ?, ß 2 microglobuline