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Association of Acute Kidney Injury with Bronchopulmonary Dysplasia in Preterm Infants

Saime Hacer Ozdemir1, Husnu Fahri Ovali1

  • 1Medeniyet University Faculty of Medicine, Department of Pediatrics, Istanbul, Türkiye.

Medeniyet Medical Journal
|October 1, 2024
PubMed

Insights

Acute kidney injury (AKI) in premature infants was linked to a higher incidence of bronchopulmonary dysplasia (BPD). This study explored the association between AKI and BPD development in preterm infants, highlighting increased morbidities in those with AKI.

Area of Science:

  • Neonatal Medicine
  • Pediatric Nephrology
  • Neonatal Respiratory Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a common complication in premature infants, associated with significant morbidity and mortality.
  • Acute kidney injury (AKI) is also prevalent in premature infants, independently increasing mortality and morbidity.
  • Emerging evidence suggests systemic effects of AKI may negatively impact lung development and function.

Purpose of the Study:

  • To investigate the association between acute kidney injury (AKI) and the development of bronchopulmonary dysplasia (BPD) in preterm infants.
  • To analyze demographic factors and perinatal/postnatal morbidities in preterm infants with and without AKI.
  • To determine if AKI influences the incidence or severity of BPD in a vulnerable neonatal population.

Main Methods:

  • Retrospective study of preterm infants with a postconceptional age of ≤32 weeks and/or birth weight of ≤1500 grams.
  • Comparison of BPD incidence between infants with and without diagnosed AKI during the neonatal period.
  • Analysis of clinical data including gestational age, birth weight, need for resuscitation, mechanical ventilation, and associated morbidities.

Main Results:

  • The incidence of BPD was higher in infants with AKI (52.6%) compared to those without AKI (38.3%).
  • Infants with AKI experienced increased requirements for resuscitation and invasive mechanical ventilation, with fewer ventilator-free days.
  • AKI was associated with higher rates of sepsis, patent ductus arteriosus, necrotizing enterocolitis, and hemodynamic instability.

Conclusions:

  • While a higher rate of BPD was observed in preterm infants with AKI, the difference was not statistically significant (p>0.05).
  • AKI in preterm infants is linked to a greater burden of respiratory and systemic morbidities, including increased need for respiratory support.
  • Further research is warranted to elucidate the complex interplay between AKI and BPD and to identify potential therapeutic targets.
Abstract

Keywords:
Prematurityacute kidney injurybronchopulmonary dysplasiaorgan crosstalk

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