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Am J Perinatol 2018; 35(03): 298-304
DOI: 10.1055/s-0037-1607213
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Factors and Outcomes of Persistent Pulmonary Hypertension of the Newborn Associated with Acute Kidney Injury in Thai Neonates

Wuttichart Kamolvisit
1   Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai, Songkhla, Thailand
,
Sutthikiat Jaroensri
1   Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai, Songkhla, Thailand
,
Benthira Ratchatapantanakorn
2   Department of Health System Development, Hat Yai Hospital, Hat Yai, Songkhla, Thailand
,
Narongsak Nakwan
1   Department of Pediatrics, Hat Yai Medical Education Center, Hat Yai, Songkhla, Thailand
› Author Affiliations Funding None.
Further Information

Publication History

03 June 2017

28 August 2017

Publication Date:
10 October 2017 (online)

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Abstract

Objective This study aims to determine the risk factors and outcome of persistent pulmonary hypertension of the newborn (PPHN)-associated acute kidney injury (AKI).

Study Design Infants diagnosed with PPHN at Hat Yai Hospital from January 2012 to December 2016 were retrospectively reviewed.

Results Of the 109 included PPHN infants, 28.4% (31/109) died, and AKI was found in 28.4% following neonatal KDIGO classification. Of the 31, 19 who died (61.3%) reached stage 1, 3 (9.7%) reached stage 2, and 9 (29.0%) reached stage 3. AKI (all stages combined) was significantly associated with increased mortality with an odds ratio (OR) of 8.71 (95% confidence interval [CI], 3.37–22.49). Multivariate logistic regression analysis indicated that male gender (adjusted OR = 8.56; 95% CI = 0.84–85.09) and urine output of < 1 mL/kg/h in 12 hours of admission (adjusted OR = 15.57; 95% CI = 2.58–93.98) were the main factors associated with an increased risk for AKI, while birth by cesarean delivery was associated with reduced risk of AKI (adjusted OR = 0.10; 95% CI = 0.16–0.68).

Conclusion The incidence of AKI in PPHN was high in this study, and this complication was also significantly associated with higher mortality. In PPHN neonates, AKI should be especially closely monitored in males and infants who have a urine output of < 1 mL/kg/h in the first 12 hours of admission.

Keywords

persistent pulmonary hypertension of the newborn - neonatal mortality - acute kidney injury - acute renal failure - newborn infant
 

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