Journal article
Low albumin levels are independently associated with neonatal acute kidney injury: a report from AWAKEN Study Group
Pediatric nephrology (Berlin, West), Vol.37(7), pp.1675-1686
07/01/2022
DOI: 10.1007/s00467-021-05295-2
PMCID: PMC9986677
PMID: 34657971
Abstract
Background Data from adult and pediatric literature have shown an association between albumin levels and AKI. Whether hypoalbuminemia and neonatal AKI are associated has not been studied. Methods We evaluated the association of albumin with early (during the first postnatal week) and late (after the first postnatal week) AKI for 531 neonates from the Assessment of Worldwide AKI Epidemiology in Neonates (AWAKEN) database and for 3 gestational age (GA) subgroups: < 29, 29 to < 36, and >= 36 weeks GA. Results Low albumin levels were associated with increased odds of neonatal AKI; for every 0.1 g/dL decrease in albumin, the odds of late AKI increased by 12% on continuous analysis. After adjustment for potential confounders, neonates with albumin values in the lowest quartiles (< 2.2 g/dL) had an increased odds of early [Adjusted Odd Ratio (AdjOR) 2.5, 95% CI = 1.1-5.3, p < 0.03] and late AKI [AdjOR 13.4, 95% CI = 3.6-49.9, p < 0.0001] compared to those with albumin in the highest quartile (> 3.1 g/dL). This held true for albumin levels 2.3 to 2.6 g/dL for early [AdjOR 2.5, 95% CI = 1.2-5.5, p < 0.02] and late AKI [AdjOR 6.4, 95% CI = 1.9-21.6, p < 0.01]. Albumin quartiles of (2.7 to 3.0 g/dL) were associated with increased odds of late AKI. Albumin levels of 2.6 g/dL and 2.4 g/dL best predicted early (AUC = 0.59) and late AKI (AUC = 0.64), respectively. Analysis of albumin association with AKI by GA is described. Conclusions Low albumin levels are independently associated with early and late neonatal AKI. Albumin could be a potential modifiable risk factor for neonatal AKI.
Details
- Title: Subtitle
- Low albumin levels are independently associated with neonatal acute kidney injury: a report from AWAKEN Study Group
- Creators
- Arwa Nada - Le Bonheur Children's HospitalDavid Askenazi - University of Alabama at BirminghamJuan C. Kupferman - Maimonides Medical CenterMaroun Mhanna - Louisiana State University in ShreveportJohn D. Mahan - Nationwide Children's HospitalLouis Boohaker - University of Alabama at BirminghamLinzi Li - University of Alabama at BirminghamRussell L. Griffin - University of Alabama at BirminghamAWAKEN Collaborative
- Contributors
- Tarah T Colaizy (Contributor) - University of Iowa, NeonatologyJonathan M Klein (Contributor) - University of Iowa, Neonatology
- Resource Type
- Journal article
- Publication Details
- Pediatric nephrology (Berlin, West), Vol.37(7), pp.1675-1686
- DOI
- 10.1007/s00467-021-05295-2
- PMID
- 34657971
- PMCID
- PMC9986677
- NLM abbreviation
- Pediatr Nephrol
- ISSN
- 0931-041X
- eISSN
- 1432-198X
- Publisher
- Springer Nature
- Number of pages
- 12
- Grant note
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester UL1TR001449 / Clinical and Translational Science Center (CTSC) Micah Batchelor Foundation Section of Pediatric Nephrology, Department of Pediatrics, Texas Children's Hospital Children's of Alabama U54TR001356 / University of Iowa Institute for Clinical and Translational Science 100 Women Who Care Canberra Hospital Private Practice Fund Stony Brook Children's Hospital Department of Pediatrics Edward Mallinckrodt Department of Pediatrics at Washington University School of Medicine Department of Pediatrics & Communicable Disease, C.S. Mott Children's Hospital, University of Michigan Cincinnati Children's Hospital Center for Acute Care Nephrology Department of Pediatrics, UAB School of Medicine UL1TR003096 / UAB's Center for Clinical and Translational Sciences (CCTS)
- Language
- English
- Date published
- 07/01/2022
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984354008602771
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