Relationship of patent ductus arteriosus management with neonatal AKI

Askenazi, David; Ambalavanan, Namasivayam; Griffin, Russell; Goldstein, Stuart L.; Nathan, Amy T.; Greenberg, J. M.; Kent, Alison; Fletcher, Jeffrey J.; Sethna, Farah; Soranno, Danielle E.; Gien, Jason; Gist, Katja M.; Fuloria, Mamta; Reidy, Kim; Kastel, Frederick; Uy, Natalie; Revenis, Mary; Perrazo, Sofia; Rastogi, Shantanu; Schwartz, George; D’Angio, Carl T.; Guillet, Ronnie; Rademacher, Erin; Samra, Ahmed El; Mian, Ayesa; Kupferman, Juan C.; Bhutada, Alok; Zappitelli, Michael; Wintermark, Pia; Wazir, Sanjay; Sethi, Sidharth Kumar; Dubey, Sandeep; Mhanna, Maroun J.; Kumar, Deepak; Raina, Rupesh; Ingraham, Susan E.; Nada, Arwa; Bonachea, Elizabeth; Fine, Richard Ν.; Woroniecki, Robert; Sridhar, Shanthy; Ariken, Ayse; Rhee, Christopher J.; Milner, Lawrence S.; Smith, Alexandra; Nicoletta, Julie; Mammen, Cherry; Singh, Avash; Synnes, Anne; Colaizy, Tarah T.; Klein, Jonathan M.; Brophy, Patrick D.; Chishti, Aftab S.; Hanna, Mina; Abitbol, Carolyn; DeFreitas, Marissa; Duara, Shahnaz; Yasin, Salih; Selewski, David T.; Sarker, Subrata; Wong, Craig S.; Staples, Amy; Ohls, Robin K.; Joseph, Catherine; DuPont, Tara L.; Charlton, Jennifer R.; Swanson, Jonathan; Harer, Matthew W.; Ray, Patricio E.; Hingorani, Sangeeta; Hu, C.; Juul, Sandra E.

doi:10.1038/s41372-021-01054-1

Cited by 12 publications

(5 citation statements)

References 19 publications

(29 reference statements)

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“…Patent ductus arteriosus (PDA) is an important clinical issue for preterm infants and is associated with a higher risk of AKI. 28,29 PDA represents a clinical challenge as AKI may result if it is left untreated; however, classic PDA therapies may also be associated with AKI. While NSAID treatment of PDA added an additional risk for mild AKI, severe AKI was less likely when NSAID treatment was effective.…”

Section: Preterm Neonatesmentioning

confidence: 99%

Advances in Neonatal Acute Kidney Injury

et al. 2021

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In this state-of-the-art review, we highlight the major advances over the last 5 years in neonatal acute kidney injury (AKI). Large multicenter studies reveal that neonatal AKI is common and independently associated with increased morbidity and mortality. The natural course of neonatal AKI, along with the risk factors, mitigation strategies, and the role of AKI on short- and long-term outcomes, is becoming clearer. Specific progress has been made in identifying potential preventive strategies for AKI, such as the use of caffeine in premature neonates, theophylline in neonates with hypoxic-ischemic encephalopathy, and nephrotoxic medication monitoring programs. New evidence highlights the importance of the kidney in “crosstalk” between other organs and how AKI likely plays a critical role in other organ development and injury, such as intraventricular hemorrhage and lung disease. New technology has resulted in advancement in prevention and improvements in the current management in neonates with severe AKI. With specific continuous renal replacement therapy machines designed for neonates, this therapy is now available and is being used with increasing frequency in NICUs. Moving forward, biomarkers, such as urinary neutrophil gelatinase–associated lipocalin, and other new technologies, such as monitoring of renal tissue oxygenation and nephron counting, will likely play an increased role in identification of AKI and those most vulnerable for chronic kidney disease. Future research needs to be focused on determining the optimal follow-up strategy for neonates with a history of AKI to detect chronic kidney disease.

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Section: Preterm Neonatesmentioning

confidence: 99%

Advances in Neonatal Acute Kidney Injury

et al. 2021

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“…This is supported by findings demonstrating lower renal oxygen saturation (Rsat) values among extremely premature infants with hsPDA [8]. A recent study demonstrated that infants diagnosed with PDA had higher maximum creatinine concentrations and a three-fold higher risk of developing AKI [9].…”

Section: Introductionmentioning

confidence: 80%

“…8 A recent study demonstrated that infants diagnosed with PDA had higher maximum creatinine concentrations and a three-fold higher risk of developing AKI. 9 Identifying AKI in neonates remains challenging. One of the most commonly utilized definitions is the neonatal modified Kidney Disease Improving Global Outcomes (KDIGO) criteria.…”

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confidence: 99%

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Renal Oxygen Saturations and Acute Kidney Injury in the Preterm Infant with Patent Ductus Arteriosus

et al. 2023

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Objective: Decreased near-infrared spectroscopy (NIRS) measures of renal oxygen saturation (Rsat) have identified preterm infants with a hemodynamically significant patent ductus arteriosus (hsPDA). NIRS may further identify infants at risk for acute kidney injury (AKI) in a population with concern for hsPDA. Design: Review of infants ≤29 weeks gestation undergoing NIRS and echocardiography due to concern for hsPDA. The hsPDA was defined by two of the following: moderate-large size, left to right shunt, aortic flow reversal, left atrial enlargement. AKI was defined by neonatal modified Kidney Disease Improving Global Outcomes (KDIGO). Rsat and cerebral saturation (Csat), averaged over 1 hour, were evaluated for the 24 hour period around echocardiography. Result: Among 77 infants, 29 (38%) had AKI by neonatal modified KDIGO criteria. hsPDA was found on echocardiography in 59 (77%). There were no differences in hsPDA in infants with and without AKI (p=0.1). Rsat was not associated with AKI (p=0.3). Infants on dopamine had less Rsat variability (p<0.01). Conclusion: Rsat prior to echocardiography did not discriminate AKI in this cohort of preterm infants at risk for hsPDA, however data may not capture optimal timing of Rsat measurement before AKI.

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“…This is supported by ndings demonstrating lower renal saturation (Rsat) values among extremely premature infants with hsPDA 8 . A recent study demonstrated infants diagnosed with PDA had higher maximum creatinine concentrations and had a three-fold higher risk to develop AKI 9 .…”

Section: Introductionmentioning

confidence: 99%

Renal Saturations and Acute Kidney Injury in the Preterm Infant with Patent Ductus Arteriosus

Rose

Frymoyer

Bhombal

et al. 2022

Preprint

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Objective: Decreased near-infrared spectroscopy (NIRS) measures of renal saturation (Rsat) have identified hemodynamically significant PDA (hsPDA) and may delineate infants at risk for acute kidney injury (AKI). Design: Review of infants 29 weeks gestation undergoing NIRS and echocardiography due to concern for PDA. hsPDA was defined by two of the following: moderate-large size, left to right shunt, aortic flow reversal, left atrial enlargement. AKI was defined by neonatal KDIGO. Rsat and cerebral saturation (Csat) were evaluated for 24 hours before echocardiography. Result: Among 77 infants, hsPDA was found on echocardiography in 59 (77%). There were no differences in hsPDA in infants with and without AKI. Rsat was not associated with AKI (p=0.3) or hsPDA (p=0.5). Infants on dopamine had less Rsat variability (p=0.001). Conclusion: Rsat prior to echocardiography did not discriminate AKI in the preterm hsPDA population, however data may not capture optimal timing of Rsat measurement before AKI.

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Relationship of patent ductus arteriosus management with neonatal AKI

Cited by 12 publications

References 19 publications

Advances in Neonatal Acute Kidney Injury

Advances in Neonatal Acute Kidney Injury

Renal Oxygen Saturations and Acute Kidney Injury in the Preterm Infant with Patent Ductus Arteriosus

Renal Saturations and Acute Kidney Injury in the Preterm Infant with Patent Ductus Arteriosus

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