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Abstract: FR-PO115

Incidence, Risk Factors, and Outcomes of Neonatal AKI in Very Low Birth Weight Infants: A Retrospective Cohort Study in a Single Neonatal Intensive Care Unit in Japan

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Hidawa, Erika, Department of Pediatrics, Saitama Medical University, Iruma, Saitama, Japan
  • Hotta, Naomi, Department of Neonatology, Saitama Medial University, Iruma, Saitama, Japan
  • Sakurai, Hayato, Department of Neonatology, Saitama Medial University, Iruma, Saitama, Japan
  • Kakei, Hiroko, Department of Neonatology, Saitama Medial University, Iruma, Saitama, Japan
  • Honda, Masakazu, Department of Neonatology, Saitama Medial University, Iruma, Saitama, Japan
  • Kunikata, Tetsuya, Department of Neonatology, Saitama Medial University, Iruma, Saitama, Japan
  • Akioka, Yuko, Department of Pediatrics, Saitama Medical University, Iruma, Saitama, Japan
Background

Premature neonates are at high risk of chronic kidney disease (CKD) due to low nephron number at birth. In very low birth weight (VLBW) infants, acte kidney injury (AKI) is common during admitted to the neonatal intensive care unit (NICU). AKI is a greater long-term risk of CKD. This study was aimed to determin the incidence, risk factors and outcomes of AKI in VLBW infants admitted to the NICU.

Methods

In this study, VLBW infants hospitalized between January 2014 and March 2020 in our NICU were enrolled. We examined the incidence of AKI, and analyzed the association with detailed maternal history, neonatal history, anthropometry, vitals and clinical signs of neonates. The diagnosis of AKI was defined by an increase in serum creatinine (SCr)>0.3 mg/dL or urine output <1 ml/kg per hour, the neonatal modification of Kidney Disease: Improving Global Outcomes criteria.

Results

In total, 234 VLBW infants were included. Incidence of AKI was 52.7% (n=125). Factors associated with a higher risk of AKI included: gestational age, birth weight, Apgar scores at 1, Apgar scores at 5, hyperbilirubinea, pulmonary surfactant, diuretics, vasopressors, blood transfusion, steroids for fetal maturation, length of stay as show in the table. In multiple regression analysis, compared with no-AKI, AKI were associated with higher risk of indomethacin for patent ductus arteriosus (odds ratio(OR), 145.97; 95%confidence interval (CI), 17.72-1202.20), small for gestational age (OR, 0.27; 95%CI, 0.092-0.81) and preeclampsia (OR, 0.040; 95%CI, 0.0017-0.98). SCr levels at discharge are not significantly different between neonates with AKI to no-AKI.

Conclusion

Early diagnosis and timely intervention in neonates who treated with indomethacin can prevent the progression of AKI and thus improve prognoses. We suggest that those neonates should be followed up for a long term to prevent CKD.

Demographic of VLBW infants with AKI and no-AKI