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Am J Perinatol 2018; 35(01): 039-047
DOI: 10.1055/s-0037-1604470
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Acute Kidney Injury Impairs Postnatal Renal Adaptation and Increases Morbidity and Mortality in Very Low-Birth-Weight Infants

Nishant Srinivasan
1   Department of Pediatrics, University of Illinois, Chicago, Illinois
,
Alan Schwartz
1   Department of Pediatrics, University of Illinois, Chicago, Illinois
2   Department of Medical Education, University of Illinois, Chicago, Illinois
,
Eunice John
1   Department of Pediatrics, University of Illinois, Chicago, Illinois
,
Ross Price
1   Department of Pediatrics, University of Illinois, Chicago, Illinois
,
Sachin Amin
1   Department of Pediatrics, University of Illinois, Chicago, Illinois
› Author Affiliations
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Publication History

23 February 2017

28 June 2017

Publication Date:
02 August 2017 (online)

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Abstract

Objective This study aims to estimate the impact of acute kidney injury (AKI) on postnatal renal adaptation, morbidity, and mortality in very low-birth-weight (VLBW) infants.

Design We conducted a retrospective study of 457 VLBW infants admitted to a tertiary level neonatal intensive care unit (NICU) between July 2009 and April 2015. We compared patient characteristics, risk factors, serum creatinine trends, and adverse outcomes in infants with and without AKI using multivariate logistic regression analysis.

Results Incidence of AKI was 19.5%. On multivariate analysis, postnatal risk factors such as patent ductus arteriosus and vancomycin use were significantly associated with AKI. Infants with AKI had significantly higher mortality; 25/89 (28%) versus 15/368 (4%) (p < 0.001). Among survivors with AKI, bronchopulmonary dysplasia (BPD) was more prevalent (52.8 vs. 23.9%, p < 0.001), serum creatinine remained elevated for a longer duration and median length of stay extended by 38 days.

Conclusion Presence of AKI was associated with impaired postnatal renal adaptation, BPD, significantly longer stay in the NICU and higher mortality.

Keywords

acute kidney injury - very low-birth-weight infants - acute renal injury - serum creatinine trends - postnatal renal adaptation
 

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