Does Caffeine Citrate Administration Decrease Risk of Acute Kidney Injury in Hospitalized Preterm Neonates?

Abstract

Background: Acute kidney injury (AKI) is a life threatening condition with still high mortality rate in neonates. Early recognition of the risk factors and the rapid effective treatment of the contributing conditions will reduce AKI in the neonatal period. Aim of the Work: To determine association between early caffeine citrate administration and risk of acute kidney injury in hospitalized preterm neonates. Patients and Methods: This study was a prospective study that was conducted at the NICU of El Galaa Teaching Hospital. This study included 100 preterm neonates who were born alive from 32 weeks to 35 weeks of gestation. Results: There was highly statistically significant occurrence of apneaic episode in preterm babies who don't receive caffeine citrate and consequently decreased incidence of AKI in those babies. Conclusion: We concluded that caffeine citrate administration in preterm babies is associated with reduced incidence of apneaic episode and consequently reduced risk of AKI.

The Babyccino: The Role of Caffeine in the Prevention of Acute Kidney Injury in Neonates—A Literature Review

“…Four similarly constructed prospective cohort studies have been conducted in neonates of various prematurity to ascertain differences in AKI rates between caffeine- and non-caffeine-exposed babies [ 55 , 56 , 57 , 58 ]. All studies included 100 neonates each and found that neonates given caffeine had lower prevalences of AKI.…”

“…All studies included 100 neonates each and found that neonates given caffeine had lower prevalences of AKI. All four also noted lower peak SCr levels in caffeine-exposed neonates; three reached statistical significance [ 56 , 57 , 58 ].…”

“…In a slightly older cohort of neonates, Mohamed et al examined the association between early caffeine citrate administration and the risk of acute kidney injury in hospitalized neonates born at 32–35 weeks GA [ 57 ]. They found that, in caffeine-exposed neonates, sCr was lower at day 2 (0.81 mg/dL vs. 1.08 mg/dL, p < 0.001) and day 7 (0.53 mg/dL vs. 0.85 mg/dL, p < 0.001) compared to the non-exposed group.…”

“…The research to date evaluating the relationship between caffeine and AKI in premature neonates unanimously suggests that preterm babies receiving caffeine have lower rates of AKI [ 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. This relationship has also been shown to persist after multivariable adjustment [ 52 , 53 , 54 ].…”

“…There are several limitations within the existing literature surrounding caffeine and AKI in neonates. All studies to date are observational, seven of the eight studies had small sample sizes (<200), and inclusion criterion varied between studies with the definition of prematurity ranging from <30 weeks gestational age to <37-weeks gestational age [ 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ]. Only one study included term neonates [ 59 ].…”