Acute Kidney Injury Impairs Postnatal Renal Adaptation and Increases Morbidity and Mortality in Very Low-Birth-Weight Infants

Nishant Srinivasan; Alan Schwartz; Eunice John; Ross Price; Sachin Amin

doi:10.1055/s-0037-1604470

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2018; 35(01): 039-047
DOI: 10.1055/s-0037-1604470

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Acute Kidney Injury Impairs Postnatal Renal Adaptation and Increases Morbidity and Mortality in Very Low-Birth-Weight Infants

Nishant Srinivasan

¹Department of Pediatrics, University of Illinois, Chicago, Illinois

,

Alan Schwartz

¹Department of Pediatrics, University of Illinois, Chicago, Illinois

²Department of Medical Education, University of Illinois, Chicago, Illinois

,

Eunice John

¹Department of Pediatrics, University of Illinois, Chicago, Illinois

,

Ross Price

¹Department of Pediatrics, University of Illinois, Chicago, Illinois

,

Sachin Amin

¹Department of Pediatrics, University of Illinois, Chicago, Illinois

› Institutsangaben

Abstract

Objective This study aims to estimate the impact of acute kidney injury (AKI) on postnatal renal adaptation, morbidity, and mortality in very low-birth-weight (VLBW) infants.

Design We conducted a retrospective study of 457 VLBW infants admitted to a tertiary level neonatal intensive care unit (NICU) between July 2009 and April 2015. We compared patient characteristics, risk factors, serum creatinine trends, and adverse outcomes in infants with and without AKI using multivariate logistic regression analysis.

Results Incidence of AKI was 19.5%. On multivariate analysis, postnatal risk factors such as patent ductus arteriosus and vancomycin use were significantly associated with AKI. Infants with AKI had significantly higher mortality; 25/89 (28%) versus 15/368 (4%) (p < 0.001). Among survivors with AKI, bronchopulmonary dysplasia (BPD) was more prevalent (52.8 vs. 23.9%, p < 0.001), serum creatinine remained elevated for a longer duration and median length of stay extended by 38 days.

Conclusion Presence of AKI was associated with impaired postnatal renal adaptation, BPD, significantly longer stay in the NICU and higher mortality.

Keywords

acute kidney injury - very low-birth-weight infants - acute renal injury - serum creatinine trends - postnatal renal adaptation

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