Comparison of different definitions of acute kidney injury in extremely low birth weight infants

Abstract

Regardless of the definition, advanced AKI is associated with increased mortality, prolonged NICU length of stay, and poor growth in ELBW infants. SCr at 72 h of life and SCr peak may be predictable of NICU mortality.

Changes in Serum Creatinine Levels and Natural Evolution of Acute Kidney Injury with Conservative Management of Hemodynamically Significant Patent Ductus Arteriosus in Extremely Preterm Infants at 23–26 Weeks of Gestation

“…We reviewed medical charts of 97 EPT at gestation of 23-26 weeks admitted to our Neonatal Intensive Care Unit (NICU) from January 2011 to June 2014 presenting with HS PDA, and treated exclusively by a conservative approach [31,32]. We stratified the extremely preterm infants into 23-24 (n = 50) and 25-26 (n = 47) weeks' gestation, and analyzed rates of mortality and morbidities, such as necrotizing enterocolitis (NEC), BPD, and intraventricular hemorrhage (IVH) in accordance with the presence/absence of and duration of AKI stage 3 [5,16,18].…”

“…AKI events occurring during the 6-week postnatal period were detected by the neonatal modified KIDGO sCr criteria [5,16,18] (Table 1). Measuring a chemistry panel including sCr q 1-3 days is usual at our NICU if the infant's condition is critical during the first few weeks of life, and increasing the interval up to q 1-2 weeks, if the infant's condition has become stabilized.…”

“…Assessing kidney function is crucial for meticulous fluid, electrolyte, and nutritional support, and the adjustment of medication dosage in extremely preterm infants (EPT) [1][2][3][4]. Serum creatinine level (sCr) is a commonly used in evaluating renal function and could also be applied in assessment of glomerular filtration rate (GFR) in neonates and infants [4][5][6][7]. However, the use of sCr for renal function assessment in preterm infants is problematic as their sCr at birth reflects maternal levels [8,9], and sCr is quite variable according to gestational age (GA), birth weight, and chronological age [4,7,10,11].…”

“…However, the use of sCr for renal function assessment in preterm infants is problematic as their sCr at birth reflects maternal levels [8,9], and sCr is quite variable according to gestational age (GA), birth weight, and chronological age [4,7,10,11]. Limited data are available on how sCr is affected by gestational age and birth weight and how this value changes over time, especially in the peri-viable EPT [5,7,10,[12][13][14]. Despite these limitations, all the three current available acute kidney injury (AKI) definitions use change in sCr to classify the stage of AKI in the newborn infants [5,15,16].…”

“…Limited data are available on how sCr is affected by gestational age and birth weight and how this value changes over time, especially in the peri-viable EPT [5,7,10,[12][13][14]. Despite these limitations, all the three current available acute kidney injury (AKI) definitions use change in sCr to classify the stage of AKI in the newborn infants [5,15,16].…”