Recurrent acute kidney injury in preterm neonates is common and associated with worse outcomes and higher mortality
Background Acute kidney injury (AKI) in preterm neonates is associated with poor outcomes that may worsen in the setting of recurrent episodes of AKI. This study defines and studies the incidence, risk factors, and outcomes of recurrent AKI (rAKI). Methods Retrospective chart review of the neonates...
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| Veröffentlicht in: | Pediatric research 2022-07, Vol.92 (1), p.284-290 |
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| creator | Adegboyega, Oluwatobi O. Singh, Yamini Bhutada, Alok Kupferman, Juan C. Rastogi, Shantanu |
| description | Background
Acute kidney injury (AKI) in preterm neonates is associated with poor outcomes that may worsen in the setting of recurrent episodes of AKI. This study defines and studies the incidence, risk factors, and outcomes of recurrent AKI (rAKI).
Methods
Retrospective chart review of the neonates born at a gestational age of ≤28 weeks admitted to the neonatal intensive care unit (NICU) between January 2014 and December 2018. We identified AKI based on the serum creatinine (Scr) concentrations using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. rAKI was defined as the occurrence of AKI after Scr from the prior AKI had returned to baseline.
Results
Forty-nine of the 205 (24%) preterm neonates developed rAKI. An earlier diagnosis ( |
| doi_str_mv | 10.1038/s41390-021-01740-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2578773163</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2706506007</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-e7f977a1e2054050f75d5ed85f8f9990d50e9d76f895209592bf40eba63d58b63</originalsourceid><addsrcrecordid>eNp9kc1LxDAQxYMouH78A54CXrxUJ03TNEcRv0AQRM8h2053s26TNUmR_vdmXUHw4OnBzO89ZniEnDG4ZMCbq1gxrqCAkhXAZAXFtEdmTPA8qiq5T2YAnBVcqeaQHMW4AmCVaKoZiS_YjiGgS9S0Y0L6bjuHE7VuNYat0E3AhGGgDr0zCSO1kbZ-GLyjxnXUxOhbmxcd_bRpST99iEj9mDKT4S2ytIslBjr4kMzapumEHPRmHfH0R4_J293t681D8fR8_3hz_VS0XJSpQNkrKQ3DEkQFAnopOoFdI_qmV0pBJwBVJ-u-UaIEJVQ57yvAual5J5p5zY_JxS53E_zHiDHpwcYW12uTfxmjLoVspOSs5hk9_4Ou_Bhcvk6XEmoBNYDMVLmj2uBjDNjrTbCDCZNmoLc96F0POvegv3vQUzbxnSlm2C0w_Eb_4_oCrQiM7A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2706506007</pqid></control><display><type>article</type><title>Recurrent acute kidney injury in preterm neonates is common and associated with worse outcomes and higher mortality</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Adegboyega, Oluwatobi O. ; Singh, Yamini ; Bhutada, Alok ; Kupferman, Juan C. ; Rastogi, Shantanu</creator><creatorcontrib>Adegboyega, Oluwatobi O. ; Singh, Yamini ; Bhutada, Alok ; Kupferman, Juan C. ; Rastogi, Shantanu</creatorcontrib><description>Background
Acute kidney injury (AKI) in preterm neonates is associated with poor outcomes that may worsen in the setting of recurrent episodes of AKI. This study defines and studies the incidence, risk factors, and outcomes of recurrent AKI (rAKI).
Methods
Retrospective chart review of the neonates born at a gestational age of ≤28 weeks admitted to the neonatal intensive care unit (NICU) between January 2014 and December 2018. We identified AKI based on the serum creatinine (Scr) concentrations using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. rAKI was defined as the occurrence of AKI after Scr from the prior AKI had returned to baseline.
Results
Forty-nine of the 205 (24%) preterm neonates developed rAKI. An earlier diagnosis (<7 days old) and a higher KDIGO stage (stage 3) at the initial episode of AKI was associated with rAKI (
p
= 0.03). Preterm neonates with rAKI had higher mortality as compared to those with a single episode of AKI (sAKI) (adjusted odds ratio (aOR) 4.55, 95% confidence interval (CI), 1.12–18.51). Length of stay (LOS) was longer among neonates with rAKI as compared to those with sAKI by 36 days (95% CI 24.9–47.1).
Conclusions
Recurrent AKI in preterm neonates was associated with earlier episodes and higher KDIGO stage of the initial AKI episode. Neonates with rAKI had higher mortality and longer LOS compared to those with sAKI.
Impact
Definition and study of the incidence of rAKI and its associated outcomes among preterm neonates.
Recurrent AKI is common among preterm neonates and may contribute to worse outcomes for premature neonates in the NICU.
Early recognition of the risk factors for AKI, and effective management of initial AKI and early phase of recurrent AKI may improve outcomes of these preterm neonates.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-021-01740-y</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Antibiotics ; Birth weight ; Clinical Research Article ; Cohort analysis ; Congenital diseases ; Creatinine ; Data collection ; Gestational age ; Hospitals ; Intensive care ; Kidney diseases ; Length of stay ; Medicine ; Medicine & Public Health ; Mortality ; Multiple births ; Nonsteroidal anti-inflammatory drugs ; Pediatric Surgery ; Pediatrics ; Risk factors ; Ventilators</subject><ispartof>Pediatric research, 2022-07, Vol.92 (1), p.284-290</ispartof><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021</rights><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-e7f977a1e2054050f75d5ed85f8f9990d50e9d76f895209592bf40eba63d58b63</citedby><cites>FETCH-LOGICAL-c352t-e7f977a1e2054050f75d5ed85f8f9990d50e9d76f895209592bf40eba63d58b63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids></links><search><creatorcontrib>Adegboyega, Oluwatobi O.</creatorcontrib><creatorcontrib>Singh, Yamini</creatorcontrib><creatorcontrib>Bhutada, Alok</creatorcontrib><creatorcontrib>Kupferman, Juan C.</creatorcontrib><creatorcontrib>Rastogi, Shantanu</creatorcontrib><title>Recurrent acute kidney injury in preterm neonates is common and associated with worse outcomes and higher mortality</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><description>Background
Acute kidney injury (AKI) in preterm neonates is associated with poor outcomes that may worsen in the setting of recurrent episodes of AKI. This study defines and studies the incidence, risk factors, and outcomes of recurrent AKI (rAKI).
Methods
Retrospective chart review of the neonates born at a gestational age of ≤28 weeks admitted to the neonatal intensive care unit (NICU) between January 2014 and December 2018. We identified AKI based on the serum creatinine (Scr) concentrations using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. rAKI was defined as the occurrence of AKI after Scr from the prior AKI had returned to baseline.
Results
Forty-nine of the 205 (24%) preterm neonates developed rAKI. An earlier diagnosis (<7 days old) and a higher KDIGO stage (stage 3) at the initial episode of AKI was associated with rAKI (
p
= 0.03). Preterm neonates with rAKI had higher mortality as compared to those with a single episode of AKI (sAKI) (adjusted odds ratio (aOR) 4.55, 95% confidence interval (CI), 1.12–18.51). Length of stay (LOS) was longer among neonates with rAKI as compared to those with sAKI by 36 days (95% CI 24.9–47.1).
Conclusions
Recurrent AKI in preterm neonates was associated with earlier episodes and higher KDIGO stage of the initial AKI episode. Neonates with rAKI had higher mortality and longer LOS compared to those with sAKI.
Impact
Definition and study of the incidence of rAKI and its associated outcomes among preterm neonates.
Recurrent AKI is common among preterm neonates and may contribute to worse outcomes for premature neonates in the NICU.
Early recognition of the risk factors for AKI, and effective management of initial AKI and early phase of recurrent AKI may improve outcomes of these preterm neonates.</description><subject>Antibiotics</subject><subject>Birth weight</subject><subject>Clinical Research Article</subject><subject>Cohort analysis</subject><subject>Congenital diseases</subject><subject>Creatinine</subject><subject>Data collection</subject><subject>Gestational age</subject><subject>Hospitals</subject><subject>Intensive care</subject><subject>Kidney diseases</subject><subject>Length of stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Multiple births</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Risk factors</subject><subject>Ventilators</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1LxDAQxYMouH78A54CXrxUJ03TNEcRv0AQRM8h2053s26TNUmR_vdmXUHw4OnBzO89ZniEnDG4ZMCbq1gxrqCAkhXAZAXFtEdmTPA8qiq5T2YAnBVcqeaQHMW4AmCVaKoZiS_YjiGgS9S0Y0L6bjuHE7VuNYat0E3AhGGgDr0zCSO1kbZ-GLyjxnXUxOhbmxcd_bRpST99iEj9mDKT4S2ytIslBjr4kMzapumEHPRmHfH0R4_J293t681D8fR8_3hz_VS0XJSpQNkrKQ3DEkQFAnopOoFdI_qmV0pBJwBVJ-u-UaIEJVQ57yvAual5J5p5zY_JxS53E_zHiDHpwcYW12uTfxmjLoVspOSs5hk9_4Ou_Bhcvk6XEmoBNYDMVLmj2uBjDNjrTbCDCZNmoLc96F0POvegv3vQUzbxnSlm2C0w_Eb_4_oCrQiM7A</recordid><startdate>20220701</startdate><enddate>20220701</enddate><creator>Adegboyega, Oluwatobi O.</creator><creator>Singh, Yamini</creator><creator>Bhutada, Alok</creator><creator>Kupferman, Juan C.</creator><creator>Rastogi, Shantanu</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20220701</creationdate><title>Recurrent acute kidney injury in preterm neonates is common and associated with worse outcomes and higher mortality</title><author>Adegboyega, Oluwatobi O. ; Singh, Yamini ; Bhutada, Alok ; Kupferman, Juan C. ; Rastogi, Shantanu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-e7f977a1e2054050f75d5ed85f8f9990d50e9d76f895209592bf40eba63d58b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antibiotics</topic><topic>Birth weight</topic><topic>Clinical Research Article</topic><topic>Cohort analysis</topic><topic>Congenital diseases</topic><topic>Creatinine</topic><topic>Data collection</topic><topic>Gestational age</topic><topic>Hospitals</topic><topic>Intensive care</topic><topic>Kidney diseases</topic><topic>Length of stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Multiple births</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Risk factors</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adegboyega, Oluwatobi O.</creatorcontrib><creatorcontrib>Singh, Yamini</creatorcontrib><creatorcontrib>Bhutada, Alok</creatorcontrib><creatorcontrib>Kupferman, Juan C.</creatorcontrib><creatorcontrib>Rastogi, Shantanu</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adegboyega, Oluwatobi O.</au><au>Singh, Yamini</au><au>Bhutada, Alok</au><au>Kupferman, Juan C.</au><au>Rastogi, Shantanu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recurrent acute kidney injury in preterm neonates is common and associated with worse outcomes and higher mortality</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><date>2022-07-01</date><risdate>2022</risdate><volume>92</volume><issue>1</issue><spage>284</spage><epage>290</epage><pages>284-290</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Background
Acute kidney injury (AKI) in preterm neonates is associated with poor outcomes that may worsen in the setting of recurrent episodes of AKI. This study defines and studies the incidence, risk factors, and outcomes of recurrent AKI (rAKI).
Methods
Retrospective chart review of the neonates born at a gestational age of ≤28 weeks admitted to the neonatal intensive care unit (NICU) between January 2014 and December 2018. We identified AKI based on the serum creatinine (Scr) concentrations using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. rAKI was defined as the occurrence of AKI after Scr from the prior AKI had returned to baseline.
Results
Forty-nine of the 205 (24%) preterm neonates developed rAKI. An earlier diagnosis (<7 days old) and a higher KDIGO stage (stage 3) at the initial episode of AKI was associated with rAKI (
p
= 0.03). Preterm neonates with rAKI had higher mortality as compared to those with a single episode of AKI (sAKI) (adjusted odds ratio (aOR) 4.55, 95% confidence interval (CI), 1.12–18.51). Length of stay (LOS) was longer among neonates with rAKI as compared to those with sAKI by 36 days (95% CI 24.9–47.1).
Conclusions
Recurrent AKI in preterm neonates was associated with earlier episodes and higher KDIGO stage of the initial AKI episode. Neonates with rAKI had higher mortality and longer LOS compared to those with sAKI.
Impact
Definition and study of the incidence of rAKI and its associated outcomes among preterm neonates.
Recurrent AKI is common among preterm neonates and may contribute to worse outcomes for premature neonates in the NICU.
Early recognition of the risk factors for AKI, and effective management of initial AKI and early phase of recurrent AKI may improve outcomes of these preterm neonates.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><doi>10.1038/s41390-021-01740-y</doi><tpages>7</tpages></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Antibiotics Birth weight Clinical Research Article Cohort analysis Congenital diseases Creatinine Data collection Gestational age Hospitals Intensive care Kidney diseases Length of stay Medicine Medicine & Public Health Mortality Multiple births Nonsteroidal anti-inflammatory drugs Pediatric Surgery Pediatrics Risk factors Ventilators |
| title | Recurrent acute kidney injury in preterm neonates is common and associated with worse outcomes and higher mortality |
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