TY - JOUR
T1 - Late onset neonatal acute kidney injury
T2 - results from the AWAKEN Study
AU - Charlton, Jennifer R.
AU - Boohaker, Louis
AU - Askenazi, David
AU - Brophy, Patrick D.
AU - Fuloria, Mamta
AU - Gien, Jason
AU - Griffin, Russell
AU - Hingorani, Sangeeta
AU - Ingraham, Susan
AU - Mian, Ayesa
AU - Ohls, Robin K.
AU - Rastogi, Shantanu
AU - Rhee, Christopher J.
AU - Revenis, Mary
AU - Sarkar, Subrata
AU - Starr, Michelle
AU - Kent, Alison L.
AU - Ambalavanan, Namasivayam
AU - Selewski, David T.
AU - Fletcher, Jeffery
AU - Abitbol, Carolyn L.
AU - DeFreitas, Marissa
AU - Duara, Shahnaz
AU - Guillet, Ronnie
AU - Rademacher, Erin
AU - D’Angio, Carl
AU - Mhanna, Maroun J.
AU - Raina, Rupesh
AU - Kumar, Deepak
AU - Arikan, Ayse Akcan
AU - Goldstein, Stuart L.
AU - Nathan, Amy T.
AU - Kupferman, Juan C.
AU - Bhutada, Alok
AU - Bonachea, Elizabeth
AU - Mahan, John
AU - Nada, Arwa
AU - Jetton, Jennifer
AU - Colaizy, Tarah T.
AU - Klein, Jonathan M.
AU - Cole, F. Sessions
AU - Davis, T. Keefe
AU - Milner, Lawrence
AU - Smith, Alexandra
AU - Reidy, Kimberly
AU - Kaskel, Frederick J.
AU - Gist, Katja M.
AU - Hanna, Mina H.
AU - Wong, Craig S.
AU - Joseph, Catherine
N1 - Publisher Copyright:
© 2019, International Pediatric Research Foundation, Inc.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Background: 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). Methods: 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. Results: 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. Conclusions: 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.
AB - Background: 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). Methods: 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. Results: 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. Conclusions: 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.
UR - http://www.scopus.com/inward/record.url?scp=85060724912&partnerID=8YFLogxK
U2 - 10.1038/s41390-018-0255-x
DO - 10.1038/s41390-018-0255-x
M3 - Article
SN - 0031-3998
VL - 85
SP - 339
EP - 348
JO - Pediatric Research
JF - Pediatric Research
IS - 3
ER -