Journal article
Optimizing the AKI definition during first postnatal week using Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) cohort
Pediatric research, Vol.85(3), pp.329-338
02/01/2019
DOI: 10.1038/s41390-018-0249-8
PMCID: PMC6377843
PMID: 30643188
Abstract
BACKGROUND: Neonates with serum creatinine (SCr) rise >= 0.3 mg/dL and/or >= 50% SCr rise are more likely to die, even when controlling for confounders. These thresholds have not been tested in newborns. We hypothesized that different gestational age (GA) groups require different SCr thresholds.
METHODS: Neonates in Assessment of Worldwide Acute Kidney Epidemiology in Neonates (AWAKEN) with >= 1 SCr on postnatal days 1-2 and >= 1 SCr on postnatal days 3-8 were assessed. We compared the mortality predictability of SCr absolute (>= 0.3 mg/dL) vs percent (>= 50%) rise. Next, we determine usefulness of combining absolute with percent rise. Finally, we determined the optimal absolute, percent, and maximum SCr thresholds that provide the highest mortality area under curve (AUC) and specificity for different GA groups.
RESULTS: The >= 0.3 mg/dL rise outperformed >= 50% SCr rise. Addition of percent rise did not improve mortality predictability. The optimal SCr thresholds to predict AUC and specificity were and >= 0.3 mg/dL >= 0.6 mg/dL for <= 29 weeks GA, and and >= 0.1 and >= 0.3 mg/dL for >29 week GA. The maximum SCr value provides great specificity.
CONCLUSION: Unique SCr rise cutoffs for different GA improves outcome prediction. Percent SCr rise does not add value to the neonatal AKI definition.
Details
- Title: Subtitle
- Optimizing the AKI definition during first postnatal week using Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) cohort
- Creators
- David Askenazi - University of Alabama at BirminghamCarolyn Abitbol - University of Miami HospitalLouis Boohaker - University of Alabama at BirminghamRussell Griffin - University of Alabama at BirminghamRupesh Raina - MetroHealth Medical CenterJoshua Dower - Tufts UniversityT. Keefe Davis - Washington University in St. LouisPatricio E. Ray - George Washington UniversitySofia Perazzo - George Washington UniversityMarissa DeFreitas - University of Miami HospitalLawrence Milner - Tufts UniversityNamasivayam Ambalavanan - University of Alabama at BirminghamF. Sessions Cole - Washington University in St. LouisErin Rademacher - Golisano Children's HospitalMichael Zappitelli - Hospital for Sick ChildrenMaroun Mhanna - MetroHealth Medical CenterDavid T. Selewski - Univ Michigan, CS Mott Childrens Hosp, Ann Arbor, MI 48109 USASubrata Sarkar - Univ Michigan, CS Mott Childrens Hosp, Ann Arbor, MI 48109 USAAlison Kent - Centenary InstituteJeffery Fletcher - Centenary InstituteShahnaz Duara - University of MiamiJennifer R. Charlton - University of VirginiaJonathan R. Swanson - University of VirginiaRonnie Guillet - University of RochesterCarl D'Angio - University of RochesterAyesa Mian - University of RochesterDeepak Kumar - Case Western Reserve UniversityJennifer G. Jetton - Univ Iowa, Childrens Hosp, Iowa City, IA USAPatrick D. Brophy - University of IowaTarah T. Colaizy - University of IowaJonathan M. Klein - University of IowaAyse Akcan Arikan - Texas Children's HospitalChristopher J. Rhee - Texas Children's HospitalStuart L. Goldstein - Cincinnati Children's Hospital Medical CenterAmy T. Nathan - Cincinnati Children's Hospital Medical CenterJuan C. Kupferman - Maimonides Hosp, Brooklyn, NY 11219 USAAlok Bhutada - Maimonides Hosp, Brooklyn, NY 11219 USAShantanu Rastogi - Maimonides Hosp, Brooklyn, NY 11219 USAElizabeth Bonachea - Nationwide Childrens Hosp, Columbus, OH USAJohn Mahan - Nationwide Childrens Hosp, Columbus, OH USAAlexandra Smith - Tufts UniversityMamta Fuloria - The Bronx DefendersKimberly Reidy - The Bronx DefendersFrederick J. Kaskel - The Bronx DefendersDanielle E. Soranno - Univ Colorado, Childrens Hosp Colorado, Aurora, CO USAJason Gien - Univ Colorado, Childrens Hosp Colorado, Aurora, CO USAKatja M. Gist - Univ Colorado, Childrens Hosp Colorado, Aurora, CO USAAftab S. Chishti - University of KentuckyMina H. Hanna - University of KentuckySangeeta Hingorani - University of WashingtonMichelle Starr - University of WashingtonSunny Juul - University of WashingtonCraig S. Wong - Univ New Mexico, Hlth Sci Ctr, Albuquerque, NM 87131 USACatherine Joseph - University of New MexicoTara DuPont - University of New MexicoRobin Ohis - Univ New Mexico, Hlth Sci Ctr, Albuquerque, NM 87131 USAAmy Staples - University of New MexicoSurender Khokhar - Apollo Cradle, Gurgaon, Haryana, IndiaMary Revenis - George Washington UniversitySidharth K. Sethi - Medanta, Medic, Gurgaon, IndiaSmriri Rohatgi - Medanta, Medic, Gurgaon, IndiaCherry Mammen - British Columbia Childrens Hosp, Vancouver, BC, CanadaAnne Synnes - British Columbia Childrens Hosp, Vancouver, BC, CanadaSanjay Wazir - CloudninePia Wintermark - McGill UniversityRobert Woroniecki - Stony Brook MedicineShanty Sridhar - Stony Brook MedicineSusan Ingraham - University of Hawaii SystemArwa Nada - University of Tennessee at KnoxvilleNeonatal Kidney Collaborative
- Resource Type
- Journal article
- Publication Details
- Pediatric research, Vol.85(3), pp.329-338
- Publisher
- Springer Nature
- DOI
- 10.1038/s41390-018-0249-8
- PMID
- 30643188
- PMCID
- PMC6377843
- ISSN
- 0031-3998
- eISSN
- 1530-0447
- Number of pages
- 10
- Grant note
- U54TR001356 / University of Iowa Institute for Clinical and Translational Science R01DK103608 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) R01FD005092 / FOOD AND DRUG ADMINISTRATION; United States Department of Health & Human Services UL1TR001417 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) UL1TR001449 / Clinical and Translational Science Center (CTSC, NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA UL1TR001417 / UAB's Center for Clinical and Translational Sciences (CCTS, NIH) Children's of Alabama Hospital, the Department of Pediatrics, UAB School of Medicine Cincinnati Children's Hospital Center for Acute Care Nephrology
- Language
- English
- Date published
- 02/01/2019
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984353798502771
Metrics
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