Late onset neonatal acute kidney injury: results from the AWAKEN Study

on behalf of the Neonatal Kidney Collaborative (NKC)

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Most studies of neonatal acute kidney injury (AKI) have focused on the first week following birth. Here, we determined the outcomes and risk factors for late AKI (>7d). Methods: The international AWAKEN study examined AKI in neonates admitted to an intensive care unit. Late AKI was defined as occurring >7 days after birth according to the KDIGO criteria. Models were constructed to assess the association between late AKI and death or length of stay. Unadjusted and adjusted odds for late AKI were calculated for each perinatal factor. Results: Late AKI occurred in 202/2152 (9%) of enrolled neonates. After adjustment, infants with late AKI had higher odds of death (aOR:2.1, p = 0.02) and longer length of stay (parameter estimate: 21.9, p < 0.001). Risk factors included intubation, oligo- and polyhydramnios, mild-moderate renal anomalies, admission diagnoses of congenital heart disease, necrotizing enterocolitis, surgical need, exposure to diuretics, vasopressors, and NSAIDs, discharge diagnoses of patent ductus arteriosus, necrotizing enterocolitis, sepsis, and urinary tract infection. Conclusions: Late AKI is common, independently associated with poor short-term outcomes and associated with unique risk factors. These should guide the development of protocols to screen for AKI and research to improve prevention strategies to mitigate the consequences of late AKI.

Original languageEnglish (US)
Pages (from-to)339-348
Number of pages10
JournalPediatric Research
Volume85
Issue number3
DOIs
StatePublished - Feb 1 2019

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Acute Kidney Injury
Necrotizing Enterocolitis
Length of Stay
Parturition
Newborn Infant
Oligohydramnios
Polyhydramnios
Patent Ductus Arteriosus
Non-Steroidal Anti-Inflammatory Agents
Diuretics
Intubation
Urinary Tract Infections
Intensive Care Units
Heart Diseases
Sepsis
Kidney

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Late onset neonatal acute kidney injury : results from the AWAKEN Study. / on behalf of the Neonatal Kidney Collaborative (NKC).

In: Pediatric Research, Vol. 85, No. 3, 01.02.2019, p. 339-348.

Research output: Contribution to journalArticle

on behalf of the Neonatal Kidney Collaborative (NKC) 2019, 'Late onset neonatal acute kidney injury: results from the AWAKEN Study', Pediatric Research, vol. 85, no. 3, pp. 339-348. https://doi.org/10.1038/s41390-018-0255-x
on behalf of the Neonatal Kidney Collaborative (NKC). / Late onset neonatal acute kidney injury : results from the AWAKEN Study. In: Pediatric Research. 2019 ; Vol. 85, No. 3. pp. 339-348.
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abstract = "Background: Most studies of neonatal acute kidney injury (AKI) have focused on the first week following birth. Here, we determined the outcomes and risk factors for late AKI (>7d). Methods: The international AWAKEN study examined AKI in neonates admitted to an intensive care unit. Late AKI was defined as occurring >7 days after birth according to the KDIGO criteria. Models were constructed to assess the association between late AKI and death or length of stay. Unadjusted and adjusted odds for late AKI were calculated for each perinatal factor. Results: Late AKI occurred in 202/2152 (9{\%}) of enrolled neonates. After adjustment, infants with late AKI had higher odds of death (aOR:2.1, p = 0.02) and longer length of stay (parameter estimate: 21.9, p < 0.001). Risk factors included intubation, oligo- and polyhydramnios, mild-moderate renal anomalies, admission diagnoses of congenital heart disease, necrotizing enterocolitis, surgical need, exposure to diuretics, vasopressors, and NSAIDs, discharge diagnoses of patent ductus arteriosus, necrotizing enterocolitis, sepsis, and urinary tract infection. Conclusions: Late AKI is common, independently associated with poor short-term outcomes and associated with unique risk factors. These should guide the development of protocols to screen for AKI and research to improve prevention strategies to mitigate the consequences of late AKI.",
author = "{on behalf of the Neonatal Kidney Collaborative (NKC)} and Charlton, {Jennifer R.} and Louis Boohaker and David Askenazi and Brophy, {Patrick D.} and Mamta Fuloria and Jason Gien and Russell Griffin and Sangeeta Hingorani and Susan Ingraham and Ayesa Mian and Ohls, {Robin K.} and Shantanu Rastogi and Rhee, {Christopher J.} and Mary Revenis and Subrata Sarkar and Michelle Starr and Kent, {Alison L.} and Namasivayam Ambalavanan and Selewski, {David T.} and Jeffery Fletcher and Carolyn Abitbol and Marissa DeFreitas and Shahnaz Duara and Ronnie Guillet and Erin Rademacher and Carl D’Angio and Mhanna, {Maroun J.} and Rupesh Raina and Deepak Kumar and Arikan, {Ayse Akcan} and Goldstein, {Stuart L.} and Nathan, {Amy T.} and Kupferman, {Juan C.} and Alok Bhutada and Elizabeth Bonachea and John Mahan and Arwa Nada and Jennifer Jetton and Colaizy, {Tarah T.} and Klein, {Jonathan M.} and Cole, {F. Sessions} and Davis, {T. Keefe} and Lawrence Milner and Alexandra Smith and Kimberly Reidy and Kaskel, {Frederick J.} and Gist, {Katja M.} and Hanna, {Mina H.} and Wong, {Craig S.} and Catherine Joseph",
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T2 - results from the AWAKEN Study

AU - on behalf of the Neonatal Kidney Collaborative (NKC)

AU - Charlton, Jennifer R.

AU - Boohaker, Louis

AU - Askenazi, David

AU - Brophy, Patrick D.

AU - Fuloria, Mamta

AU - Gien, Jason

AU - Griffin, Russell

AU - Hingorani, Sangeeta

AU - Ingraham, Susan

AU - Mian, Ayesa

AU - Ohls, Robin K.

AU - Rastogi, Shantanu

AU - Rhee, Christopher J.

AU - Revenis, Mary

AU - Sarkar, Subrata

AU - Starr, Michelle

AU - Kent, Alison L.

AU - Ambalavanan, Namasivayam

AU - Selewski, David T.

AU - Fletcher, Jeffery

AU - Abitbol, Carolyn

AU - DeFreitas, Marissa

AU - Duara, Shahnaz

AU - Guillet, Ronnie

AU - Rademacher, Erin

AU - D’Angio, Carl

AU - Mhanna, Maroun J.

AU - Raina, Rupesh

AU - Kumar, Deepak

AU - Arikan, Ayse Akcan

AU - Goldstein, Stuart L.

AU - Nathan, Amy T.

AU - Kupferman, Juan C.

AU - Bhutada, Alok

AU - Bonachea, Elizabeth

AU - Mahan, John

AU - Nada, Arwa

AU - Jetton, Jennifer

AU - Colaizy, Tarah T.

AU - Klein, Jonathan M.

AU - Cole, F. Sessions

AU - Davis, T. Keefe

AU - Milner, Lawrence

AU - Smith, Alexandra

AU - Reidy, Kimberly

AU - Kaskel, Frederick J.

AU - Gist, Katja M.

AU - Hanna, Mina H.

AU - Wong, Craig S.

AU - Joseph, Catherine

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Background: Most studies of neonatal acute kidney injury (AKI) have focused on the first week following birth. Here, we determined the outcomes and risk factors for late AKI (>7d). Methods: The international AWAKEN study examined AKI in neonates admitted to an intensive care unit. Late AKI was defined as occurring >7 days after birth according to the KDIGO criteria. Models were constructed to assess the association between late AKI and death or length of stay. Unadjusted and adjusted odds for late AKI were calculated for each perinatal factor. Results: Late AKI occurred in 202/2152 (9%) of enrolled neonates. After adjustment, infants with late AKI had higher odds of death (aOR:2.1, p = 0.02) and longer length of stay (parameter estimate: 21.9, p < 0.001). Risk factors included intubation, oligo- and polyhydramnios, mild-moderate renal anomalies, admission diagnoses of congenital heart disease, necrotizing enterocolitis, surgical need, exposure to diuretics, vasopressors, and NSAIDs, discharge diagnoses of patent ductus arteriosus, necrotizing enterocolitis, sepsis, and urinary tract infection. Conclusions: Late AKI is common, independently associated with poor short-term outcomes and associated with unique risk factors. These should guide the development of protocols to screen for AKI and research to improve prevention strategies to mitigate the consequences of late AKI.

AB - Background: Most studies of neonatal acute kidney injury (AKI) have focused on the first week following birth. Here, we determined the outcomes and risk factors for late AKI (>7d). Methods: The international AWAKEN study examined AKI in neonates admitted to an intensive care unit. Late AKI was defined as occurring >7 days after birth according to the KDIGO criteria. Models were constructed to assess the association between late AKI and death or length of stay. Unadjusted and adjusted odds for late AKI were calculated for each perinatal factor. Results: Late AKI occurred in 202/2152 (9%) of enrolled neonates. After adjustment, infants with late AKI had higher odds of death (aOR:2.1, p = 0.02) and longer length of stay (parameter estimate: 21.9, p < 0.001). Risk factors included intubation, oligo- and polyhydramnios, mild-moderate renal anomalies, admission diagnoses of congenital heart disease, necrotizing enterocolitis, surgical need, exposure to diuretics, vasopressors, and NSAIDs, discharge diagnoses of patent ductus arteriosus, necrotizing enterocolitis, sepsis, and urinary tract infection. Conclusions: Late AKI is common, independently associated with poor short-term outcomes and associated with unique risk factors. These should guide the development of protocols to screen for AKI and research to improve prevention strategies to mitigate the consequences of late AKI.

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