Use of non-conventional biomarkers in the early diagnosis of acute kidney injury in preterm newborns with sepsis

Barbosa, Joycilene Da Silva; Júnior, Geraldo Bezerra da Silva; Meneses, Gdayllon Cavalcante; Martins, Alice Maria Costa; Daher, Elizabeth De Francesco; Machado, Rosângela Pinheiro Gonçalves; Lemes, Romélia Pinheiro Gonçalves

doi:10.1590/2175-8239-jbn-2020-0222

Cited by 9 publications

(5 citation statements)

References 70 publications

(105 reference statements)

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“…In a cohort-matched study, Coggins et al reported increased rates of AKI and greater AKI severity in neonates with culture-proven sepsis [53]. The mechanism in which sepsis contributes to the development of AKI may include decreased GFR, renal vasoconstriction, and reduced local blood flow [54].…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury in Very Low Birth Weight Infants: A Major Morbidity and Mortality Risk Factor

et al. 2023

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Background and objectives: Very low birth weight (VLBW) infants are at high risk of developing acute kidney injury (AKI), presumably secondary to low kidney reserves, stressful postnatal events, and drug exposures. Our study aimed to identify the prevalence, risk factors, and outcomes associated with AKI in VLBW infants. Study design: Records of all VLBW infants admitted to two medical campuses between January 2019 and June 2020 were retrospectively reviewed. AKI was classified using the modified KDIGO definition to include only serum creatinine. Risk factors and composite outcomes were compared between infants with and without AKI. We evaluated the main predictors of AKI and death with forward stepwise regression analysis. Results: 152 VLBW infants were enrolled. 21% of them developed AKI. Based on the multivariable analysis, the most significant predictors of AKI were the use of vasopressors, patent ductus arteriosus, and bloodstream infection. AKI had a strong and independent association with neonatal mortality. Conclusions: AKI is common in VLBW infants and is a significant risk factor for mortality. Efforts to prevent AKI are necessary to prevent its harmful effects.

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Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury in Very Low Birth Weight Infants: A Major Morbidity and Mortality Risk Factor

et al. 2023

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“…On the other hand, a UTI, which, depending on its severity, can progress to AKI, is the third infectious cause most related to progression to a septic condition, behind lung and abdominal infections [27], triggering the pathophysiological condition described previously [26]. Furthermore, patients who progress with severity may require mechanical ventilation and administration of nephrotoxic drugs, which tend to increase harmful effects on renal function [28], so it is essential to explore new biomarkers, which can allow the application of interventions, evaluate responses to treatment, detect biological abnormalities, and assess the prognosis according to the development of the disease [29]. The 28th Acute Disease Quality Initiative consensus reported that SA-AKI recommends utilizing sepsis biomarkers in conjunction with functional and tubular injury-related biomarkers to enhance the prognosis of early or late SA-AKI [25].…”

Section: The Crosstalk Between Acute Kidney Injury and Sepsismentioning

confidence: 99%

The Role of Biomarkers in Diagnosis of Sepsis and Acute Kidney Injury

Ferreira,

Frota,

Gonzaga

et al. 2024

Biomedicines

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Sepsis and acute kidney injury (AKI) are two major public health concerns that contribute significantly to illness and death worldwide. Early diagnosis and prompt treatment are essential for achieving the best possible outcomes. To date, there are no specific clinical, imaging, or biochemical indicators available to diagnose sepsis, and diagnosis of AKI based on the KDIGO criterion has limitations. To improve the diagnostic process for sepsis and AKI, it is essential to continually evolve our understanding of these conditions. Delays in diagnosis and appropriate treatment can have serious consequences. Sepsis and AKI often occur together, and patients with kidney dysfunction are more prone to developing sepsis. Therefore, identifying potential biomarkers for both conditions is crucial. In this review, we talk about the main biomarkers that evolve the diagnostic of sepsis and AKI, namely neutrophil gelatinase-associated lipocalin (NGAL), proenkephalin (PENK), and cell-free DNA.

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“…Neonatal sepsis is frequently assessed in preterm newborns, secondary to pathogens acquired after birth, and is defined as early (ES) or late (LS) sepsis if diagnosis occurs within or after 72 h of birth, respectively [ 80 ]. Neonatal sepsis is inversely related to birth weight and gestational age, with a high prevalence in very-low-birth-weight neonates [ 81 ] and with gestational age (GA) < 28 weeks [ 82 ].…”

Section: Risk Factors For Aki In Neonatal Intensive Carementioning

confidence: 99%

Acute Kidney Injury in Neonatal Intensive Care Unit: Epidemiology, Diagnosis and Risk Factors

Chirico,

Lacquaniti,

Tripodi

et al. 2024

JCM

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Acute kidney injury (AKI) is associated with long-term consequences and poor outcomes in the neonatal intensive care unit. Its precocious diagnosis represents one of the hardest challenges in clinical practice due to the lack of sensitive and specific biomarkers. Currently, neonatal AKI is defined with urinary markers and serum creatinine (sCr), with limitations in early detection and individual treatment. Biomarkers and risk factor scores were studied to predict neonatal AKI, to early identify the stage of injury and not the damage and to anticipate late increases in sCr levels, which occurred when the renal function already began to decline. Sepsis is the leading cause of AKI, and sepsis-related AKI is one of the main causes of high mortality. Moreover, preterm neonates, as well as patients with post-neonatal asphyxia or after cardiac surgery, are at a high risk for AKI. Critical patients are frequently exposed to nephrotoxic medications, representing a potentially preventable cause of AKI. This review highlights the definition of neonatal AKI, its diagnosis and new biomarkers available in clinical practice and in the near future. We analyze the risk factors involving patients with AKI, their outcomes and the risk for the transition from acute damage to chronic kidney disease.

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Use of non-conventional biomarkers in the early diagnosis of acute kidney injury in preterm newborns with sepsis

Cited by 9 publications

References 70 publications

Acute Kidney Injury in Very Low Birth Weight Infants: A Major Morbidity and Mortality Risk Factor

Acute Kidney Injury in Very Low Birth Weight Infants: A Major Morbidity and Mortality Risk Factor

The Role of Biomarkers in Diagnosis of Sepsis and Acute Kidney Injury

Acute Kidney Injury in Neonatal Intensive Care Unit: Epidemiology, Diagnosis and Risk Factors

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