Journal article
Association of early dysnatremia with mortality in the neonatal intensive care unit: results from the AWAKEN study
Journal of perinatology, Vol.42(10), pp.1353-1360
10/01/2022
DOI: 10.1038/s41372-021-01260-x
PMCID: PMC10228559
PMID: 34775486
Abstract
Objective To determine the association of dysnatremia in the first postnatal week and risk of acute kidney injury (AKI) and mortality. Study design A secondary analysis of 1979 neonates in the AWAKEN cohort evaluated the association of dysnatremia with (1) AKI in the first postnatal week and (2) mortality, utilizing time-varying Cox proportional hazard models. Result Dysnatremia developed in 50.2% of the cohort and was not associated with AKI. Mortality was associated with hyponatremia (HR 2.15, 95% CI 1.07-4.31), hypernatremia (HR 4.23, 95% CI 2.07-8.65), and combined hypo/hypernatremia (HR 6.39, 95% CI 2.01-14.01). In stratified models by AKI-status, hypernatremia and hypo/hypernatremia increased risk of mortality in neonates without AKI. Conclusion Dysnatremia within the first postnatal week was associated with increased risk of mortality. Hypernatremia and combined hypo/hypernatremia remained significantly associated with mortality in neonates without AKI. This may reflect fluid strategies kidney injury independent of creatinine and urine-output defined AKI, and/or systemic inflammation.
Details
- Title: Subtitle
- Association of early dysnatremia with mortality in the neonatal intensive care unit: results from the AWAKEN study
- Creators
- Abby M. Basalely - Children's Hospital at MontefioreRussell Griffin - University of Alabama at BirminghamKatja M. Gist - Children's Hospital ColoradoRonnie Guillet - University of Rochester Medical CenterDavid J. Askenazi - University of Alabama at BirminghamJennifer R. Charlton - University of VirginiaDavid T. Selewski - Medical University of South CarolinaMamta Fuloria - Children's Hospital at MontefioreFrederick J. Kaskel - Children's Hospital at MontefioreKimberly J. Reidy - The Bronx DefendersAWAKEN Study Group
- Contributors
- Tarah Colaizy (Contributor) - University of Iowa, NeonatologyJonathan Klein (Contributor) - University of Iowa, Neonatology
- Resource Type
- Journal article
- Publication Details
- Journal of perinatology, Vol.42(10), pp.1353-1360
- DOI
- 10.1038/s41372-021-01260-x
- PMID
- 34775486
- PMCID
- PMC10228559
- NLM abbreviation
- J Perinatol
- ISSN
- 0743-8346
- eISSN
- 1476-5543
- Publisher
- Springer Nature
- Number of pages
- 8
- Grant note
- U54TR001356 / University of Iowa Institute for Clinical and Translational Science 5T32DK007110- 46 / NIH T32 NIDDK Canberra Hospital Private Practice Fund Children's of Alabama hospital UL1TR001449 / Clinical and Translational Science Center at The University of New Mexico (National Institutes of Health); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA UL1TR002556 / NIH/NCATS Einstein-Montefiore CTSA Grant UL1TR001417 / UAB Department of Pediatrics, UAB School of Medicine, and UAB Center for Clinical and Translational Sciences (National Institutes of Health) 100 Women Charitable Foundation Pediatric and Infant Center for Acute Nephrology (PICAN) Cincinnati Children's Hospital Center for Acute Care Nephrology
- Language
- English
- Date published
- 10/01/2022
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984353833202771
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