Journal article
Late onset neonatal acute kidney injury: results from the AWAKEN Study
Pediatric research, Vol.85(3), pp.339-348
02/2019
DOI: 10.1038/s41390-018-0255-x
PMCID: PMC6438709
PMID: 30546043
Abstract
Most studies of neonatal acute kidney injury (AKI) have focused on the first week following birth. Here, we determined the outcomes and risk factors for late AKI (>7d).
The international AWAKEN study examined AKI in neonates admitted to an intensive care unit. Late AKI was defined as occurring >7 days after birth according to the KDIGO criteria. Models were constructed to assess the association between late AKI and death or length of stay. Unadjusted and adjusted odds for late AKI were calculated for each perinatal factor.
Late AKI occurred in 202/2152 (9%) of enrolled neonates. After adjustment, infants with late AKI had higher odds of death (aOR:2.1, p = 0.02) and longer length of stay (parameter estimate: 21.9, p < 0.001). Risk factors included intubation, oligo- and polyhydramnios, mild-moderate renal anomalies, admission diagnoses of congenital heart disease, necrotizing enterocolitis, surgical need, exposure to diuretics, vasopressors, and NSAIDs, discharge diagnoses of patent ductus arteriosus, necrotizing enterocolitis, sepsis, and urinary tract infection.
Late AKI is common, independently associated with poor short-term outcomes and associated with unique risk factors. These should guide the development of protocols to screen for AKI and research to improve prevention strategies to mitigate the consequences of late AKI.
Details
- Title: Subtitle
- Late onset neonatal acute kidney injury: results from the AWAKEN Study
- Creators
- Jennifer R Charlton - University of Virginia Children's HospitalLouis Boohaker - University of Alabama at BirminghamDavid Askenazi - University of Alabama at BirminghamPatrick D Brophy - Golisano Children's HospitalMamta Fuloria - Children's Hospital at MontefioreJason Gien - Children's Hospital ColoradoRussell Griffin - University of Alabama at BirminghamSangeeta Hingorani - Seattle Children's HospitalSusan Ingraham - Kapiolani Medical Center for Women and ChildrenAyesa Mian - Golisano Children's HospitalRobin K Ohls - University of New MexicoShantanu Rastogi - Maimonides Medical CenterChristopher J Rhee - Texas Children's HospitalMary Revenis - George Washington UniversitySubrata Sarkar - C. S. Mott Children's HospitalMichelle Starr - Seattle Children's HospitalAlison L Kent - Golisano Children's HospitalNeonatal Kidney Collaborative (NKC)
- Contributors
- Tarah T Colaizy (Contributor) - University of Iowa, NeonatologyJonathan M Klein (Contributor) - University of Iowa, Neonatology
- Resource Type
- Journal article
- Publication Details
- Pediatric research, Vol.85(3), pp.339-348
- DOI
- 10.1038/s41390-018-0255-x
- PMID
- 30546043
- PMCID
- PMC6438709
- ISSN
- 0031-3998
- eISSN
- 1530-0447
- Grant note
- K08 DK109226 / NIDDK NIH HHS UL1 TR001417 / NCATS NIH HHS UL1 TR001449 / NCATS NIH HHS T32 DK007662 / NIDDK NIH HHS UL1 TR003096 / NCATS NIH HHS
- Language
- English
- Date published
- 02/2019
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984354008002771
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