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Acute Kidney Injury in Very Low Birth Weight Infants: A Major Morbidity and Mortality Risk Factor

Gilad Lazarovits1,2, Noa Ofek Shlomai1,2, Raed Kheir2

  • 1Department of Neonatology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel.

Children (Basel, Switzerland)
|February 25, 2023
PubMed

Insights

Acute kidney injury (AKI) affects 21% of very low birth weight (VLBW) infants. This condition significantly increases the risk of neonatal mortality, highlighting the need for preventative strategies.

Area of Science:

  • Neonatology
  • Pediatric Nephrology
  • Critical Care Medicine

Background:

  • Very low birth weight (VLBW) infants possess diminished kidney reserves, making them susceptible to acute kidney injury (AKI).
  • Postnatal stressors and medication exposure further elevate the risk of AKI in this vulnerable population.

Purpose of the Study:

  • To determine the prevalence of AKI in VLBW infants.
  • To identify risk factors associated with AKI development in VLBW infants.
  • To investigate the outcomes, including mortality, linked to AKI in VLBW infants.

Main Methods:

  • Retrospective review of VLBW infants admitted between January 2019 and June 2020.
  • AKI classification based on the modified KDIGO definition using serum creatinine.
  • Multivariable regression analysis to identify predictors of AKI and mortality.

Main Results:

  • The study enrolled 152 VLBW infants, with 21% developing AKI.
  • Significant predictors of AKI included vasopressor use, patent ductus arteriosus, and bloodstream infection.
  • AKI was independently associated with increased neonatal mortality.

Conclusions:

  • Acute kidney injury is a prevalent complication in VLBW infants.
  • AKI is a significant independent risk factor for mortality in this population.
  • Preventive measures against AKI are crucial to improve outcomes for VLBW infants.
Abstract

Keywords:
acute kidney injurybloodstream infectionspatent ductus arteriosusprematuritypreterm birthvasopressorsvery low birth weight

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