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Recurrent neonatal acute kidney injury: incidence, predictors, and outcomes in the neonatal intensive care unit

Journal of Perinatology volume 44, pages 428–433 (2024)Cite this article

Subjects

Abstract

Objective

Determine recurrent neonatal acute kidney injury (rAKI) incidence, risk factors, and associated outcomes.

Study design

Single-center retrospective cohort of neonates admitted to the NICU 1/1/20-6/30/21. Comparisons were made between those with no AKI, single AKI episode (sAKI), and rAKI. Multivariable linear and logistic regression models were used to assess associations between rAKI and length of mechanical ventilation (LMV), length of hospitalization stay (LOS), mortality, and hypertension (HTN) at discharge.

Results

The incidence of AKI in the cohort of 869 infants was 19%: 705 (81%) no AKI, 100 (12%) sAKI, 64 (7%) rAKI. Both sAKI and rAKI were independently associated with longer LMV and LOS. sAKI was independently associated with almost 4x higher odds of mortality than rAKI.

Conclusion

In this single center cohort of neonates, sAKI independently predicts mortality, however rAKI is independently associated with increased LMV and LOS suggesting rAKI is clinically important and warrants further study.

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Data availability

Data are not able to shared in a public repository due to IRB restrictions. Please contact the primary author by email for inquiries about the dataset used in this study.

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Acknowledgements

All work for this study performed at the Medical University of South Carolina in Charleston, South Carolina.

Funding

This project was funded in part by the David and Laura Stone Endowment for Advancement in Neonatal Medicine, Division of Neonatology, Medical University of South Carolina. The authors report no external sources of funding.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA

    Katherine Vincent, Austin Rutledge, David T. Selewski & Heidi J. Steflik

  2. Department of Pediatrics, Cincinnati Children’s Medical Center, Cincinnati, OH, USA

    Zegilor Laney

  3. Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Jill C. Newman

Authors
  1. Katherine Vincent
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  2. Austin Rutledge
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  3. Zegilor Laney
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  4. Jill C. Newman
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  5. David T. Selewski
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  6. Heidi J. Steflik
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Contributions

KV contributed to the conception and design of this work, the acquisition, analysis, and interpretation of data, drafted and revised the paper, approved the final version and agrees to be accountable or all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. DS and HS contributed to conception and design of the work, analysis and interpretation of the data, critical revision for important intellectual content of this paper, approves the final version and agrees to be accountable for all aspects of the work. AR and ZL performed data collection, edited paper, approves the final version and agrees to be accountable for all aspects of the work. JN performed statistical analysis, assisted with study design, edited paper, approves the final version and agrees to be accountable for all aspects of the work.

Corresponding author

Correspondence to Katherine Vincent.

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The authors declare no competing interests.

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Vincent, K., Rutledge, A., Laney, Z. et al. Recurrent neonatal acute kidney injury: incidence, predictors, and outcomes in the neonatal intensive care unit. J Perinatol 44, 428–433 (2024). https://doi.org/10.1038/s41372-023-01800-7

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