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Acute kidney injury surveillance in the high-risk neonatal population following implementation of creatinine screening protocol
Journal article   Open access   Peer reviewed

Acute kidney injury surveillance in the high-risk neonatal population following implementation of creatinine screening protocol

Alyssa R Gingrich, Allison M Hagenow, Emily J Steinbach, Jonathan M Klein, Jennifer G Jetton and Jason M Misurac
Acta paediatrica (Oslo, Norway : 1992), Vol.113(4), pp.692-699
04/2024
DOI: 10.1111/apa.17055
PMID: 38084834
url
https://doi.org/10.1111/apa.17055View
Published (Version of record) Open Access

Abstract

Acute kidney injury (AKI) in neonates is associated with longer hospital stays and higher mortality rates. However, there is significant variability in prevalence rates of AKI and the true burden is incompletely understood. In November 2020, the University of Iowa Stead Family Children's Hospital Neonatal Intensive Care Unit implemented a creatinine screening protocol to enhance kidney function monitoring. We sought to evaluate adherence to the protocol to determine if increased surveillance led to increased detection of AKI events. A retrospective chart review was conducted for neonates born at <30 weeks' gestation admitted between 2015 and 2020. We reviewed 100 charts in both the pre (2015-2016) and post (2020-2021) implementation era of the AKI surveillance protocol. AKI was defined according to neonatal modified KDIGO criteria. Following implementation of the protocol, neonates were significantly more likely to have creatinine checked (p < 0.001). Serum creatinine was drawn according to protocol guidelines 68% of the time, and 42% of patients (34/82) had an 80% or higher adherence to the protocol. There was a significant increase in detection of AKI in the post-protocol cohort (13/82, incidence of 16%) compared to the pre-protocol cohort (5/83, incidence of 6%), (p = 0.047). The implementation of a serum creatinine screening protocol increased the frequency of creatinine draws and detection of AKI.
neonatal intensive care unit acute kidney injury paediatric nephrology serum creatinine UIOWA OA Agreement

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