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

Nishant Srinivasan1, Alan Schwartz1,2, Eunice John1

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

American Journal of Perinatology
|August 3, 2017
PubMed

Insights

Acute kidney injury (AKI) affects nearly 20% of very low-birth-weight (VLBW) infants, leading to higher mortality and complications like bronchopulmonary dysplasia (BPD). AKI also impairs renal adaptation and prolongs NICU stays.

Area of Science:

  • Neonatology
  • Pediatric Nephrology
  • Critical Care Medicine

Background:

  • Very low-birth-weight (VLBW) infants are susceptible to kidney injury.
  • Postnatal renal adaptation is crucial for VLBW infant outcomes.
  • Acute kidney injury (AKI) is a significant concern in neonatal intensive care units (NICUs).

Purpose of the Study:

  • To estimate the impact of AKI on postnatal renal adaptation in VLBW infants.
  • To assess the association between AKI and morbidity/mortality in VLBW infants.
  • To identify risk factors for AKI in VLBW infants.

Main Methods:

  • Retrospective study of 457 VLBW infants admitted to a tertiary NICU.
  • Comparison of patient characteristics, risk factors, and outcomes between infants with and without AKI.
  • Multivariate logistic regression analysis to identify significant associations.

Main Results:

  • The incidence of AKI was 19.5% among VLBW infants.
  • Patent ductus arteriosus and vancomycin use were significant risk factors for AKI.
  • Infants with AKI had higher mortality (28% vs. 4%), increased BPD (52.8% vs. 23.9%), prolonged elevated serum creatinine, and longer NICU stays.

Conclusions:

  • AKI is associated with impaired postnatal renal adaptation in VLBW infants.
  • AKI significantly increases morbidity, including BPD, and mortality.
  • AKI leads to longer NICU stays and delayed renal recovery.
Abstract

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