Recurrent Neonatal Acute Kidney Injury: Incidence, Predictors, and Outcomes in the Neonatal Intensive Care Unit

Author:

Vincent Katherine1,Rutledge Austin1ORCID,Laney Zegilor1,Newman Jill,Selewski David1,Steflik Heidi1ORCID

Affiliation:

1. Medical University of South Carolina

Abstract

Abstract Objective: Determine recurrent neonatal acute kidney injury (rAKI) incidence, risk factors, and associated outcomes. Study Design: Single-center retrospective cohort of neonates admitted to the NICU 1/1/20-6/30/21. Comparisons were made between those with no AKI, single episode AKI (sAKI), and rAKI. Multivariable linear and logistic regression models were used to assess associations between rAKI and length of mechanical ventilation (LMV), length of hospitalization stay (LOS), mortality, and hypertension (HTN) at discharge. Results: The incidence of AKI in the cohort of 869 infants was 19%: 705 (81%) no AKI, 100 (12%) sAKI, 64 (7%) rAKI. Both sAKI and rAKI were independently associated with longer LMV and LOS. sAKI was independently associated with almost 4x higher odds of mortality than rAKI. Conclusion: In this single center cohort of neonates, sAKI independently predicts mortality, however rAKI is independently associated with increased LMV and LOS suggesting rAKI is clinically important and warrants further study.

Publisher

Research Square Platform LLC

Reference12 articles.

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2. Harer MW, Selewski DT, Kashani K, Basu RK, Gist KM, Jetton JG, et al. Improving the quality of neonatal acute kidney injury care: neonatal-specific response to the 22nd Acute Disease Quality Initiative (ADQI) conference. J Perinatol. 2021;41(2):185 – 95.

3. Incidence and Risk Factors of Early Onset Neonatal AKI;Charlton JR;Clin J Am Soc Nephrol,2019

4. Maternal and environmental risk factors for neonatal AKI and its long-term consequences;Perico N;Nat Rev Nephrol,2018

5. Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation;Starr MC;Am J Perinatol,2020

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