Risk factors associated with acute kidney injury in extremely low birth weight (ELBW) infants

Viswanathan, S.; Manyam, Bindu V.; Azhibekov, Timur; Mhanna, Maroun J.

doi:10.1007/s00467-011-1977-8

Cited by 121 publications

(83 citation statements)

References 39 publications

(75 reference statements)

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“…After adjusting for potential confounders, those with AKI had a significantly higher chance of death (hazard ratio 2.4, 95% confidence interval [CI] 0.95-6.0; P , .06). Viswanathan et al 65 reported similar findings in a retrospective singlecenter study, where 12.5% (59/472) of all ELBW infants developed AKI and mortality among those with AKI was significantly higher than controls (70% vs 22%, respectively). In a large retrospective study of VLBW infants, Carmody et al 66 examined 455 VLBW infants and found an AKI incidence of 39.8%.…”

Section: Vlbw and Elbw Neonatessupporting

confidence: 54%

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Neonatal Acute Kidney Injury

et al. 2015

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In recent years, there have been significant advancements in our understanding of acute kidney injury (AKI) and its impact on outcomes across medicine. Research based on single-center cohorts suggests that neonatal AKI is very common and associated with poor outcomes. In this state-of-the-art review on neonatal AKI, we highlight the unique aspects of neonatal renal physiology, definition, risk factors, epidemiology, outcomes, evaluation, and management of AKI in neonates. The changes in renal function with gestational and chronologic age are described. We put forth and describe the neonatal modified Kidney Diseases: Improving Global Outcomes AKI criteria and provide the rationale for its use as the standardized definition of neonatal AKI. We discuss risk factors for neonatal AKI and suggest which patient populations may warrant closer surveillance, including neonates ,1500 g, infants who experience perinatal asphyxia, near term/ term infants with low Apgar scores, those treated with extracorporeal membrane oxygenation, and those requiring cardiac surgery. We provide recommendations for the evaluation and treatment of these patients, including medications and renal replacement therapies. We discuss the need for long-term follow-up of neonates with AKI to identify those children who will go on to develop chronic kidney disease. This review highlights the deficits in our understanding of neonatal AKI that require further investigation. In an effort to begin to address these needs, the Neonatal Kidney Collaborative was formed in 2014 with the goal of better understanding neonatal AKI, beginning to answer critical questions, and improving outcomes in these vulnerable populations.

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Section: Vlbw and Elbw Neonatessupporting

confidence: 54%

“…10,65,66 In 2011, Koralkar et al 10 reported on 229 VLBW infants followed prospectively from birth until 36 weeks postmenstrual age. The incidence of AKI, by using the neonatal modified KDIGO criteria, was 18%.…”

Section: Vlbw and Elbw Neonatesmentioning

confidence: 99%

Neonatal Acute Kidney Injury

et al. 2015

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“…Retrospective studies have been undertaken to assess the prevalence and the clinical and biochemical features of AKI following clindamycin treatment (6)(7)(8). AKI related to the administration of clindamycin is generally associated with oligoanuria, the same as in our patient.…”

Section: Discussionmentioning

confidence: 87%

Clindamycin-induced Kidney Diseases: A Retrospective Analysis of 50 Patients

Wan

Wang

et al. 2016

Intern. Med.

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Objective There are many adverse reactions due to clindamycin, but kidney diseases (acute kidney injury, AKI) are uncommon. However, in recent years, the rate of clindamycin-induced kidney diseases has increased. We analyzed 50 patients with clindamycin-induced kidney diseases retrospectively, and investigated the characteristics of these kidney diseases in order to provide a reference for rational clinical drug use and to reduce drug-induced organ damage. Methods We investigated 50 patients diagnosed with clindamycin-induced kidney diseases retrospectively at the Department of Nephrology, Shandong University Qilu Hospital, from January 2009 to December 2013. The parameters included in our study were age, sex, clinical manifestations, efficacy and prognosis. Results All patients were diagnosed with clindamycin-induced kidney diseases within 48 hours of the application of clindamycin at 1.0-2.0 g/day. The patients included 29 women and 21 men. Most of the enrolled patients were 20-59 years old. Fifty-one patients were diagnosed with AKI stage 3 upon admission. Thirtythree had episodes of gross hematuria, but fever, skin rash and eosinophilia were rare. Urine analysis revealed mild proteinuria and severe tubular dysfunction. In the majority of patients, AKI was severe and required renal replacement therapy, but renal function in all patients had recovered significantly two months after discharge. Conclusion Clindamycin-induced AKI is largely reversible and is associated with episodes of gross hematuria. Clinicians should use clindamycin rationally and reduce the incidence of adverse reactions.

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“…However, in most cases, the incidence of major morbidities has changed very little, especially for extremely premature infants (1,2). Acute kidney injury (AKI), indicated by a rise in serum creatinine (SCr) occurs in approximately 12-18% of preterm neonates (3). Premature infants typically have immature renal structure and function at birth, are often exposed to nephrotoxic medications and are at high risk of AKI in the perinatal period.…”

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confidence: 99%

Early urinary biomarkers of acute kidney injury in preterm infants

et al. 2016

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Background: Acute kidney injury (AKI) in the neonatal intensive care setting is multifactorial and is associated with significant morbidity and mortality. This study evaluates the utility of novel urinary biomarkers to predict the development and/or severity AKI in preterm infants. Methods: We performed a case-control study on a prospective cohort of preterm infants (<32 wk), to compare seven urine biomarkers between 25 infants with AKI and 20 infants without AKI. results: Infants with AKI had significantly higher neutrophil gelatinase-associated lipocalin (NGAL) (median, control (CTRL) vs. AKI; 0.598 vs. 4.24 µg/ml; P < 0.0001). In contrast, urinary epidermal growth factor (EGF) levels were significantly lower in infants who developed AKI compared to controls (median, CTRL vs. AKI; 0.016 vs. 0.006 µg/ml; P < 0.001). The area under the curve (AUC) for NGAL for prediction of stage I AKI on the day prior to AKI diagnosis (day-1) was 0.91, and for the prediction of stage II/III, AKI was 0.92. Similarly, urine EGF was a predictor of renal injury on day -1 (AUC: 0.97 for stage I and 0.86 for stage II/III AKI). conclusion: Urinary biomarkers may be useful to predict AKI development prior to changes in serum creatinine (SCr) in preterm infants.

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Risk factors associated with acute kidney injury in extremely low birth weight (ELBW) infants

Cited by 121 publications

References 39 publications

Neonatal Acute Kidney Injury

Neonatal Acute Kidney Injury

Clindamycin-induced Kidney Diseases: A Retrospective Analysis of 50 Patients

Early urinary biomarkers of acute kidney injury in preterm infants

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