Describing patterns in serum creatinine in infants with and without necrotizing enterocolitis

Han, Rachel; Bonachea, Elizabeth; Jackson, Kenneth; Conroy, Sara; Slaughter, Jonathan L.; Mahan, John D.; Mohamed, Tahagod

doi:10.1038/s41372-022-01482-7

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…11,[30][31][32] As an example, 11% of the participants with severe AKI would be misdiagnosed using serum creatinine (SCr) criteria without UOP data. 18 Han et al evaluated SCr patterns and the development of AKI as potential biomarkers of NEC in infants born at 23 to 32 weeks 33 and reported that 21.4% of neonates with NEC met criteria for AKI versus 0% in infants without NEC. The temporal change in SCr and UOP in infants with severe AKI 18 demonstrates that the rise in SCr occurs within 24 hours after NEC onset and that the SCr elevation persists to approximately 96 hours after NEC diagnosis.…”

Section: Serum Creatinine and Urine Output Trends Following Necrotizi...mentioning

confidence: 99%

Necrotizing Enterocolitis-Associated Acute Kidney Injury—Transforming the Paradigm

Garg,

Shenberger,

South

et al. 2024

Am J Perinatol

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Necrotizing enterocolitis (NEC) is one of the most common conditions requiring emergency surgery in the neonatal intensive care unit and is associated with a septic shock-like state contributing to multi-organ dysfunction. NEC affects 6-10% of very-low birth-weight infants and remains a leading cause of death. The occurrence of severe AKI following surgical NEC is a harbinger of multiple morbidities. This review presents current evidence about the clinical impact of NEC associated AKI on the clinical outcomes. Studies evaluating nephro-protective strategies to prevent AKI and its consequences are greatly needed to improve the post-operative recovery and clinical outcomes in neonates with NEC. Future observational studies and clinical trials in preterm-born infants with NEC prioritize measuring short-term (AKI) and longer term (chronic kidney disease) kidney outcomes. Impact: 1. Severe AKI (stage 2 and 3) occurs in 32.6% of neonates after NEC diagnosis and in 58.7% following surgical NEC diagnosis. 2. NEC associated AKI is associated with severe postoperative course, moderate to severe bronchopulmonary dysplasia, surgical complications, brain injury and longer hospital stay in preterm infants. 3. Severity of NEC associated AKI can be utilized by bedside providers for the prognostication of clinical outcomes in preterm infants.

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Section: Serum Creatinine and Urine Output Trends Following Necrotizi...mentioning

confidence: 99%

Necrotizing Enterocolitis-Associated Acute Kidney Injury—Transforming the Paradigm

Garg,

Shenberger,

South

et al. 2024

Am J Perinatol

View full text Add to dashboard Cite

show abstract

Timing and risk factors associated with acute kidney injury in infants with necrotizing enterocolitis

Lingasubramanian,

Hum,

Hunter

et al. 2024

J Perinatol

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Objective To evaluate the prevalence, onset, risk factors, and mortality associated with acute kidney injury (AKI) in infants with necrotizing enterocolitis (NEC). Design/Methods Retrospective study at 2 centers in infants with NEC, with/without AKI. AKI assessed by serum creatinine and urine output. Statistical tests used included t, Mann-Whitney U, Chi-square, and Fisher Exact tests. Results Among 80 eligible infants with NEC, 56 (70%) had AKI. Median onset of NEC was day 15, with median AKI onset two days (IQR, –5.75 to 0) prior to NEC onset. Vasopressors were significantly more likely to be used in infants with NEC and AKI (p = 0.009). Increased mortality (p = 0.01) was noted in infants with NEC and AKI. Conclusions The onset of AKI mostly precedes NEC onset, with moderate to severe AKI more prevalent than the milder form in infants with NEC. These infants are significantly more likely to be hemodynamically unstable and have increased mortality.

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Describing patterns in serum creatinine in infants with and without necrotizing enterocolitis

Cited by 2 publications

References 14 publications

Necrotizing Enterocolitis-Associated Acute Kidney Injury—Transforming the Paradigm

Necrotizing Enterocolitis-Associated Acute Kidney Injury—Transforming the Paradigm

Timing and risk factors associated with acute kidney injury in infants with necrotizing enterocolitis

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