Is acute kidney injury a harbinger for chronic kidney disease?

Selewski, David T.; Hyatt, Dylan M.; Bennett, Kevin M.; Charlton, Jennifer R.

doi:10.1097/mop.0000000000000587

Cited by 19 publications

(15 citation statements)

References 39 publications

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“…Stress during the neonatal period was found to have a more deleterious effect than prematurity, with factors such as late-onset circulatory collapse and kidney dysfunction being important factors that affect subsequent kidney function. It is probable that acute kidney injury is a harbinger for CKD in pediatric populations and our study supports this concept [28]. Longer duration of antibiotic or diuretic treatment had a detrimental effect on kidney function.…”

Section: Discussionsupporting

confidence: 80%

Perinatal factors contributing to chronic kidney disease in a cohort of Japanese children with very low birth weight

et al. 2020

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Background Developmental programming of chronic kidney disease (CKD) in young adults is linked to preterm birth and intrauterine growth restriction (IUGR). Which confers a higher risk of progression to chronic kidney damage in children with very low birth weight (VLBW; born weighing < 1500 g): prematurity or IUGR? Methods This is a national historical cohort study of children with VLBW cared for in perinatal medical centers in Japan. Predictive factors included three latent variables (prematurity, IUGR, stress during neonatal period) and eight observed variables (gestational age, birth weight Z-score, maternal age, duration of treatment with antibiotics and diuretics, maternal smoking, late-onset circulatory collapse, kidney dysfunction) during the perinatal period. The primary endpoint was estimated glomerular filtration rate (eGFR) at age ≥ 3 years. A structural equation model was used to examine the pathologic constitution. Results The 446 children with VLBW included 253 boys and 193 girls, of mean age 5.8 ± 2.6 years and mean eGFR 111.7 ml/min/1.73 m2 at last encounter. Pathway analyses showed intrauterine malnutrition (β = 0.85) contributed more to chronic kidney damage than stress during the neonatal period (β = − 0.19) and prematurity (β = 0.12), and kidney dysfunction and late-onset circulatory collapse were important observed variables in stress during the neonatal period. Conclusions IUGR was more harmful to future kidneys of VLBW neonates. Neonatal kidney dysfunction and late-onset circulatory collapse were important risk factors for subsequent CKD development. This emphasizes the need for obstetricians to monitor for fetal growth restriction and neonatologists to minimize neonatal stress to prevent CKD in later life.

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Section: Discussionsupporting

confidence: 80%

Perinatal factors contributing to chronic kidney disease in a cohort of Japanese children with very low birth weight

et al. 2020

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“…AKI can have a significant impact on both short‐ and long‐term outcomes. In adults with SCD, hospital admissions complicated by AKI have been associated with an increased risk of inpatient mortality, longer length of hospital stay, an increase in admission charges and unfavourable outcomes in patients who require intensive‐care unit (ICU)‐level care (Yeruva et al , ; Baddam et al , ; Selewski et al , ). In addition, a history of acute renal failure may be predictive of an increased long‐term risk of chronic kidney disease (CKD) (Yeruva et al , ).…”

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confidence: 99%

Acute kidney injury in paediatric patients with sickle cell disease is associated with increased morbidity and resource utilization

et al. 2020

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Renal disease is a common complication experienced by patients with sickle cell disease (SCD), though the epidemiology of acute kidney injury (AKI) in paediatric patients and its impact on long-term renal outcomes is unclear. We utilized the Pediatric Health Information System (PHIS) to identify inpatient encounters of paediatric patients with SCD admitted for vaso-occlusive pain crisis (VOC). Overall, 1Á4% of patients experienced at least one episode of AKI and 2Á5% of admissions were complicated by AKI.Patients with at least one episode of AKI were more likely to be adolescents or young adults at the time of their initial admission, had increased rates of admission to the ICU, longer lengths of stay, increased costs of hospitalization, increased risk of readmission and increased rates of SCD-related comorbidities. Generalized estimating equation modelling demonstrated that increasing age, history of hypertension, history of haematuria and history of chronic kidney disease were associated with increased odds of developing AKI, though hydroxycarbamide use (OR 0Á64, 95% CI 0Á44-0Á94) was protective. Episodes of AKI during hospitalization in children with SCD are associated with increased morbidity and utilization of hospital resources. Increasing the use of hydroxycarbamide may decrease the likelihood of this complication.

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“…AKI was classified using the modified KDIGO definitions previously used in neonates ( Supplemental Table 1 ). 15 , 20 Urine output criteria were not used. For patients with multiple episodes of AKI, the highest stage of AKI reached was used for analysis.…”

Section: Methodsmentioning

confidence: 99%

“… 9 – 11 Children who survive an episode of AKI are at increased risk for repeated episodes of AKI as well as CKD. 9 , 14 , 15 Premature neonates may also be at increased risk of developing CKD as a sequelae of AKI due to their decreased nephron mass. 12 , 13 Children surviving an episode of AKI should have long-term follow-up for monitoring of their kidney function.…”

Section: Introductionmentioning

confidence: 99%

The impact of increased awareness of acute kidney injury in the Neonatal Intensive Care Unit on acute kidney injury incidence and reporting: results of a retrospective cohort study

et al. 2020

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Is acute kidney injury a harbinger for chronic kidney disease?

Abstract: AKI is common and associated with poor outcomes. It is probable that AKI is a harbinger to CKD in pediatric populations. However, we currently lack the tools to definitely answer this question and more research is needed.

Cited by 19 publications

References 39 publications

Perinatal factors contributing to chronic kidney disease in a cohort of Japanese children with very low birth weight

Perinatal factors contributing to chronic kidney disease in a cohort of Japanese children with very low birth weight

Acute kidney injury in paediatric patients with sickle cell disease is associated with increased morbidity and resource utilization

The impact of increased awareness of acute kidney injury in the Neonatal Intensive Care Unit on acute kidney injury incidence and reporting: results of a retrospective cohort study

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