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Updated: Mar 27, 2026
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Acute kidney injury in ELBW infants (< 750 grams) and its associated risk factors
Insights
Acute kidney injury (AKI) affects 26% of extremely low birth weight (ELBW) infants, significantly increasing mortality. Key risk factors include maternal complications, IVH, PDA, NEC, and prolonged ventilation or TPN.
Area of Science:
- Neonatology
- Pediatric Nephrology
- Critical Care Medicine
Background:
- Neonatal intensive care has improved survival for extremely low birth weight (ELBW) infants.
- This has led to an increased incidence of acute kidney injury (AKI) in this vulnerable population.
- Understanding AKI risk factors is crucial due to rising morbidity and mortality rates.
Purpose of the Study:
- Determine the prevalence of AKI in ELBW infants (<750 grams).
- Compare mortality rates between ELBW infants with and without AKI.
- Identify risk factors associated with AKI in ELBW infants.
Main Methods:
- Retrospective chart review of infants with AKI (AKIN criteria) admitted to NICU (1998-2008).
- Case-control matching for birth weight, gestational age, and date of birth.
- Statistical analysis using SPSS v17.0, including Student's t test, X2 test, and Mann-Whitney U test.
Main Results:
- The prevalence of AKI in ELBW infants was 26%.
- Mortality rate for ELBW infants with AKI was 54%, compared to 20% without AKI.
- Significant risk factors identified included maternal placental abruption/bleeding, Grade III/IV IVH, PDA, positive cultures, NEC, steroid use, nephrotoxic drugs, and prolonged ventilator/TPN use.
Conclusions:
- AKI is prevalent in ELBW infants, with a significant impact on survival.
- Early identification and management of associated risk factors are critical for improving outcomes.
- Further research into preventative strategies for AKI in ELBW infants is warranted.
Background:
The advancement of neonatology over the past 20 years has allowed a greater number of ELBW infants to survive. However, these advancements have contributed to the increased incidence of acute kidney injury (AKI) seen in this population. Understanding the risk factors for AKI in this population of ELBW infants is imperative for the successful survival of these infants since the morbidity and mortality rates from this disease are increasing.
Objectives:
1) to determine the prevalence of AKI in ELBW (< 750 grams). 2) to compare the mortality rate of ELBW infants (< 750 grams) with and without AKI; and 3) to identify the associated risk factors of AKI in ELBW infants (< 750 grams).
Methods:
A retrospective chart review of all infants with AKI as defined by AKIN criterias, admitted to the NICU between 1998 and 2008 was conducted. Case-controls were matched for BW, gestational age and date of birth, (SPSS v17.0 software, using Student's t test, X2 test, and Mann-Whitney U test were used for statistical analysis.
Conclusion:
The prevalence rate of ELBW infants (< 750 grams) with AKI admitted at CHMCA NICU from 1998 to 2008 was 26% . The mortality rate of ELBW infants (< 750 grams) with AKI was 54% , compared to 20% in those ELBW infants who did not have AKI. The associated risk factors of AKI in the ELBW infants (< 750 grams) were as follows: presence of maternal placental abruption/bleeding, grade III or IV IVH, PDA, positive culture/s, NEC, use of steroid, nephrotoxic drugs, and longer use of the ventilator and TPN.
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