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Abstract: SA-PO073

Epidemiology of Perioperative AKI in Neonates Undergoing Noncardiac Surgeries

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention


  • Beebe, Morgan Elizabeth, Nationwide Children's Hospital, Columbus, Ohio, United States
  • Klamer, Brett, The Ohio State University, Columbus, Ohio, United States
  • Slaughter, Jonathan L., Nationwide Children's Hospital, Columbus, Ohio, United States
  • Mohamed, Tahagod, Nationwide Children's Hospital, Columbus, Ohio, United States

The epidemiology of AKI in neonates requiring cardiac surgeries exists; however, the incidence of AKI in neonates undergoing noncardiac surgeries is not fully characterized. Our study aims to evaluate the epidemiology and outcomes of perioperative AKI (POAKI) in neonates undergoing noncardiac surgeries in the first 28 days of life at our institution. We hypothesized that noncardiac surgeries can be a risk factor for AKI, and infants who develop POAKI have worse short-term outcomes.


This is a retrospective review of neonates admitted to a single, level IV neonatal intensive care unit from Nov '14-Jan '22. Neonates aged 0-28 days who required a noncardiac surgery in the first 28 days of life were included for analysis. Neonates requiring a cardiac surgery, ECMO, had a lethal chromosomal abnormality, or with significant underlying kidney disease were excluded. Data were evaluated for the development of AKI in the 72 hours following surgery according to the neonatal modification of Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We evaluated the distribution of fluid balance in the postoperative period. Descriptive statistics were used to summarize patient characteristics. Fisher’s exact test, Pearson’s Chi-squared test, and the Wilcoxon rank sum test were used to analyze the relationship between AKI status with other variables. Statistical significance was assessed at an alpha level of 0.05.


A total of 873 neonates were included. Of those, 705 neonates had creatinine measurements available and 42% were females. The median gestational age, birthweight and age at surgery were 37 weeks, 2760 g and 4 days respectively. Abdominal, ENT, and Neuro- surgeries were most common. The rate of POAKI was 5%. With POAKI, the 1 min Apgar scores were significantly lower, postoperative day 1 fluid balance was significantly higher (11 vs 4%) and hospital mortality rates significantly higher (25 vs 4%).


In this single-center retrospective analysis, POAKI occurred in 5% of neonates requiring non-cardiac surgeries in the first 28 days of life. Low Apgar scores, fluid overload, and hospital mortality were more frequent in neonates who developed POAKI. Future work should focus on monitoring kidney health in neonates undergoing non-cardiac procedures to prevent AKI and implement effective therapies for management of fluid overload.