Late onset neonatal acute kidney injury: results from the AWAKEN Study

被引：51

作者：

Charlton, Jennifer R. ^{[1
]}

Boohaker, Louis ^{[2
]}

Askenazi, David ^{[2
]}

Brophy, Patrick D. ^{[3
]}

Fuloria, Mamta ^{[4
]}

Gien, Jason ^{[5
]}

Griffin, Russell ^{[2
]}

Hingorani, Sangeeta ^{[6
]}

Ingraham, Susan ^{[7
]}

Mian, Ayesa ^{[3
]}

Ohls, Robin K. ^{[8
]}

Rastogi, Shantanu ^{[9
]}

Rhee, Christopher J. ^{[10
]}

Revenis, Mary ^{[11
]}

Sarkar, Subrata ^{[12
]}

Starr, Michelle ^{[6
]}

Kent, Alison L. ^{[3
]}

Ambalavanan, Namasivayam ^{[13
]}

Selewski, David T. ^{[12
]}

Fletcher, Jeffery ^{[14
]}

Abitbol, Carolyn L. ^{[15
]}

DeFreitas, Marissa ^{[15
]}

Duara, Shahnaz ^{[15
]}

Guillet, Ronnie ^{[16
]}

Rademacher, Erin ^{[16
]}

D'Angio, Carl ^{[16
]}

Mhanna, Maroun J. ^{[17
]}

Raina, Rupesh ^{[17
]}

Kumar, Deepak ^{[17
]}

Arikan, Ayse Akcan ^{[10
]}

Goldstein, Stuart L. ^{[18
]}

Nathan, Amy T. ^{[18
]}

Kupferman, Juan C. ^{[19
]}

Bhutada, Alok ^{[19
]}

Bonachea, Elizabeth ^{[20
]}

Mahan, John ^{[20
]}

Nada, Arwa ^{[21
]}

Jetton, Jennifer ^{[22
]}

Colaizy, Tarah T. ^{[22
]}

Klein, Jonathan M. ^{[22
]}

Cole, F. Sessions ^{[23
]}

Davis, T. Keefe ^{[23
]}

Milner, Lawrence ^{[24
]}

Smith, Alexandra ^{[24
]}

Reidy, Kimberly ^{[25
]}

Kaskel, Frederick J. ^{[25
]}

Gist, Katja M. ^{[5
]}

Hanna, Mina H. ^{[26
]}

Wong, Craig S. ^{[27
]}

Joseph, Catherine ^{[27
]}

机构：

[1] Univ Virginia, Childrens Hosp, Charlottesville, VA 22903 USA

[2] Univ Alabama Birmingham, Birmingham, AL USA

[3] Univ Rochester, Sch Med, Golisano Childrens Hosp, Rochester, NY USA

[4] Albert Einstein Coll Med, Childrens Hosp Montefiore, Bronx, NY 10467 USA

[5] Univ Colorado, Childrens Hosp Colorado, Aurora, CO USA

[6] Univ Washington, Seattle Childrens Hosp, Seattle, WA 98195 USA

[7] Kapiolani Med Ctr Women & Children, Honolulu, HI USA

[8] Univ New Mexico, Albuquerque, NM 87131 USA

[9] Maimonides Infants & Childrens Hosp, Brooklyn, NY USA

[10] Texas Childrens Hosp, Baylor Coll Med, Houston, TX 77030 USA

[11] George Washington Univ, Childrens Natl Med Ctr, Sch Med & Hlth Sci, Washington, DC USA

[12] Univ Michigan, CS Mott Childrens Hosp, Ann Arbor, MI 48109 USA

[13] Univ Alabama Birmingham, Dept Pediat, Birmingham, AL USA

[14] Australian Natl Univ, Centenary Hosp Women & Children, Canberra Hosp, Med Sch, Canberra, ACT, Australia

[15] Univ Miami, Holtz Childrens Hosp, Miami, FL USA

[16] Univ Rochester, Golisano Childrens Hosp, Rochester, NY USA

[17] Case Western Reserve Univ, Metrohlth Med Ctr, Cleveland, OH USA

[18] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA

[19] Maimonides Hosp, Brooklyn, NY 11219 USA

[20] Nationwide Childrens Hosp, Columbus, OH USA

[21] Univ Tennessee, Ctr Hlth Sci, LeBoneur Childrens Hosp, Memphis, TN 38163 USA

[22] Univ Iowa, Childrens Hosp, Iowa City, IA USA

[23] Washington Univ, St Louis, MO USA

[24] Tufts Univ, Sch Med, Boston, MA 02111 USA

[25] Childrens Hosp Montefiore, New York, NY USA

[26] Univ Kentucky, Lexington, KY USA

[27] Univ New Mexico, Hlth Sci Ctr, Albuquerque, NM 87131 USA

[28] Apollo Cradle, Gurgaon, Haryana, India

[29] British Columbia Childrens Hosp, Vancouver, BC, Canada

[30] McGill Univ, Montreal Childrens Hosp, Hlth Ctr, Montreal, PQ, Canada

[31] Medanta Medicity, Kidney & Urol Inst, Gurgaon, India

[32] Cloudnine Hosp, Neonatol, Gurgaon, Haryana, India

[33] Medanta Medicity, Gurgaon, Haryana, India

[34] Stony Brook Sch Med, Stony Brook, NY 11794 USA

[35] Univ Virginia, Childrens Hosp, Charlottesville, VA USA

[36] Univ Toronto, Toronto Hosp Sick Children, Toronto, ON, Canada

来源：

PEDIATRIC RESEARCH | 2019年 / 85卷 / 03期

关键词：

NECROTIZING ENTEROCOLITIS; BIRTH; CPAP; OUTCOMES; INFANTS; RISK;

D O I：

10.1038/s41390-018-0255-x

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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.

引用

页码：339 / 348

页数：10

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