Incidence, risk factors, and outcome of neonatal acute kidney injury: a prospective cohort study

Shalaby, Mohamed; Sawan, Zinab A.; Nawawi, Esraa; Al-Saedi, Saad; Al-Wassia, Heidi; Kari, Jameela A.

doi:10.1007/s00467-018-3966-7

Cited by 51 publications

(37 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, while sepsis rate was more elevated in AKI stage 3 than in stage 0-2, only in EPT at gestation of 25-26 but not of 23-24 weeks, neither the presence nor the prolonged duration of AKI stage 3 was associated with elevated mortality or any morbidities rates including BPD and IVH. The reasons for our results, which are contradictory to other studies showing increased mortality and/or morbidities [2,11,[17][18][19][20][21][22][23][24], are difficult to explain. Few data are available for the peri-viable EPT of 23-24 week's gestation, and actively treated with pharmacologic agents for HS PDA could be cofounders in other studies.…”

Section: Discussioncontrasting

confidence: 99%

“…Although AKI in premature infants has been known to be related to raised mortality [11,[17][18][19][20][21] and morbidity rates, including BPD [2,22,23] and IVH [24], evidence supporting their direct causal relationships are lacking. In contrast, while sepsis rate was more elevated in AKI stage 3 than in stage 0-2, only in EPT at gestation of 25-26 but not of 23-24 weeks, neither the presence nor the prolonged duration of AKI stage 3 was associated with elevated mortality or any morbidities rates including BPD and IVH.…”

Section: Discussionmentioning

confidence: 99%

“…AKI in premature infants are known to be related to increased mortality [11,[17][18][19][20][21] and morbidities, which includes bronchopulmonary dysplasia (BPD) [2,22,23] and intraventricular hemorrhage (IVH) [24]. However, these associations have not been well reported and elucidated in EPT, although J. Clin.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Seo

Sung

Ahn

et al. 2020

JCM

View full text Add to dashboard Cite

Changes in kidney function in extremely preterm infants (EPT) with conservatively managed hemodynamically significant (HS) patent ductus arteriosus (PDA) are not known well. We aimed to present the postnatal course in serum creatinine levels (sCr), prevalence of acute kidney injury (AKI), then relevance between AKI and adverse outcomes in EPT with conservatively managed HS PDA. By review of medical records, we analyzed the postnatal course of sCr and prevalence of stage 3 AKI defined by the modified Kidney Disease Improving Global Outcome (KDIGO) in EPT at gestational age of 23 to 26 weeks with conservatively treated HS PDA. We investigated if the presence and/or prolonged duration of stage 3 AKI elevated the risk of adverse outcomes. The results showed that, neither factor was associated with adverse outcomes. While the average PDA closure date was at postnatal day (P) 41 and 53, sCr peaked at P 10 and 14 and the cumulative prevalence of stage 3 AKI was 57% and 72% in the EPT of 25-26 and 23-24 weeks' gestation, respectively. The high prevalence of stage 3 AKI without adverse outcomes in EPT with conservatively managed HS PDA suggests that it might reflect renal immaturity rather than pathologic conditions.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Seo

Sung

Ahn

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Eight studies (9.9%) enrolled pregnant mothers at varying stages after delivery [24,49,58,59,81,84,88,99]. Seventeen studies (21.0%) recruited newborns at varying stages after birth [20,21,45,52,56,63,65,66,70,73,75,92,101,102,[105][106][107][108] such as preterm babies [20,66,73,105,108] (see Additional file 3: Table S2).…”

Section: Study Characteristicsmentioning

confidence: 99%

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background: We systematically reviewed and chronicled exposures and outcomes measured in the maternal and birth cohort studies in the Gulf Cooperation Council (GCC) countries and quantitatively summarized the weighted effect estimates between maternal obesity and (1) cesarean section (CS) and (2) fetal macrosomia. Methods: We searched MEDLINE-PubMed, Embase, Cochrane Library, Scopus, and Web of Science electronic databases up to 30 June 2019. We considered all maternal and birth cohort studies conducted in the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE)). We categorized cohort studies on the basis of the exposure(s) (anthropometric, environmental, medical, maternal/reproductive, perinatal, or socioeconomic) and outcome(s) (maternal or birth) being measured. Adjusted weighted effect estimates, in the form of relative risks, between maternal obesity and CS and fetal macrosomia were generated using a randomeffects model. Results: Of 3502 citations, 81 published cohort studies were included. One cohort study was in Bahrain, eight in Kuwait, seven in Qatar, six in Oman, 52 in Saudi Arabia, and seven in the UAE. Majority of the exposures studied were maternal/reproductive (65.2%) or medical (39.5%). Birth and maternal outcomes were reported in 82.7% and in 74.1% of the cohort studies, respectively. In Saudi Arabia, babies born to obese women were at a higher risk of macrosomia (adjusted relative risk (aRR), 1.15; 95% confidence interval (CI), 1.10-1.20; I 2 = 50%) or cesarean section (aRR, 1.21; 95% CI, 1.15-1.26; I 2 = 62.0%). Several cohort studies were only descriptive without reporting the magnitude of the effect estimate between the assessed exposures and outcomes. Conclusions: Cohort studies in the GCC have predominantly focused on reproductive and medical exposures. Obese pregnant women are at an increased risk of undergoing CS delivery or macrosomic births. Longer-term studies that explore a wider range of environmental and biological exposures and outcomes relevant to the GCC region are needed. Systematic review registration: PROSPERO CRD42017068910

show abstract

“…3 The relative immaturity of the kidneys of the young infant is the possible contributing factor as illustrated by very high incidence of AKI in critically ill newborns. 11,12 Infections were the most common underlying condition in children with AKI in this study. Majority of children had lower respiratory infections (bronchiolitis/ pneumonia), followed by septic shock.…”

Section: Discussionmentioning

confidence: 66%

Acute kidney injury in paediatric intensive care: need for extended vigil

Saritha

Jayakrishnan

Ashraf

et al. 2019

Int J Contemp Pediatr

View full text Add to dashboard Cite

Background: Acute kidney injury (AKI) is an important contributor towards morbidity and mortality among critically ill children. The objective of this study was to ascertain the etiological factors, categorize the severity and determine the immediate outcome of AKI among children admitted to the pediatric intensive care unit (PICU) of a tertiary referral hospital in south India.Methods: A prospective study was conducted from January to December 2012 in the PICU, Government medical college, kozhikode, a major referral hospital in north Kerala. The institutional ethics committee approved the study. Children in the age group of 1 month to 12 years admitted to the PICU for at least 48 hours were included if they had no previous renal disease/AKI at the time of admission. Serum creatinine levels of the children were measured at the time of admission, at 48 hours, and one month later. Outcome measures included normalization of serum creatinine or persistence of impaired renal function. Mortality was assessed both immediately and after one month.Results: A total of 1716 children were included in the study, of which 107 children developed AKI (6.2%). Among the 107 children, 56 children (52.3%) were boys. Majority of children were infants 75(70.1%). Infection was the commonest underlying condition associated with AKI. Most of the children with acute kidney injury were in the earliest phase (Stage 1). Twenty-six children (24.29%) died. Among the survivors, 10% were found to have impaired renal function when followed up a month later.Conclusions: There is a high incidence of AKI in critically ill infants admitted in PICU. Residual renal impairment can persist even after discharge from hospital and these children need follow up for a longer time.

show abstract

Incidence, risk factors, and outcome of neonatal acute kidney injury: a prospective cohort study

Abstract: AKI occurred in more than half of all NICU admissions, was associated with an increased risk of mortality, and had a higher incidence among smaller and sicker infants. Therefore, close monitoring of renal function during hospitalization and after discharge is warranted in such infants.

Cited by 51 publications

References 31 publications

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

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

Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis

Acute kidney injury in paediatric intensive care: need for extended vigil

Contact Info

Product

Resources

About