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Acute kidney injury in infants diagnosed with congenital diaphragmatic hernia

Marwa M Elgendy1, Afeez Adisa2, Mohsen Farghaly2

  • 1Department of Neonatology, Cleveland Clinic Children's, Cleveland, Ohio & Department of Pediatrics, University of Florida, Jacksonville, FL, USA. Marwa.elgendy@jax.ufl.edu.

Pediatric Research
|March 23, 2023
PubMed

Insights

Infants with congenital diaphragmatic hernia (CDH) have a significantly higher risk of acute kidney injury (AKI). This increased risk of AKI in CDH infants is associated with greater use of ECMO and higher mortality rates.

Area of Science:

  • Neonatalogy
  • Pediatric Nephrology
  • Critical Care Medicine

Background:

  • Congenital diaphragmatic hernia (CDH) is associated with significant mortality despite advancements in neonatal care.
  • Infants with CDH may face an elevated risk of developing acute kidney injury (AKI).

Purpose of the Study:

  • To evaluate the prevalence and outcomes of AKI in infants diagnosed with CDH.
  • To determine the association between AKI and key outcomes in the CDH population.

Main Methods:

  • Analysis of the National Inpatient Sample dataset from 2010-2018.
  • Inclusion of term infants, comparing those with and without CDH.
  • Regression analysis was employed to assess outcomes, controlling for relevant variables.

Main Results:

  • A total of 32,042,481 term infants were analyzed, with 10,804 diagnosed with CDH.
  • The prevalence of AKI was markedly higher in infants with CDH (6.5%) compared to those without (0.05%).
  • Infants with CDH and AKI showed increased utilization of ECMO (62% vs. 17%) and higher mortality (57.3% vs. 16.7%) compared to CDH infants without AKI.

Conclusions:

  • Acute kidney injury is a significant concern in infants with congenital diaphragmatic hernia.
  • The presence of AKI in CDH infants substantially increases the likelihood of ECMO use and mortality.
Abstract

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