Assessing the prognostic impact of KDIGO criteria on acute kidney injury in very low birth weight infants: a critical insight

• Published in: Childhood kidney diseases 2024, Vol.28 (3), p.116-123
• Main Authors: Lais Fagundes Pasini, Leia de Lima Kuchart, Sarah Assoni Bilibio, Roberta Florian Santa Catarina, Breno Fauth de Araujo, Luciano da Silva Selistre, Vandrea C. de Souza
• Format: Article
• Language: Korean
• ISSN: 2384-0242; 2284-0250

Purpose: We aimed to evaluate the incidence and identify risk factors for acute kidney injury (AKI) within the first 15 days of life in very low birth weight (VLBW) infants in a neonatal intensive care unit. Additionally, we examined whether AKI correlates with increased mortality rate in this population. Methods: A prospective analysis was conducted on VLBW infants admitted to the neonatal intensive care unit from March 2017 to July 2021, diagnosing AKI based on the neonatal modified Kidney Disease: Improving Global Outcomes criteria. Neonates who died before obtaining consent, had complex malformation, or only one serum creatinine measurement were excluded. Results: Out of 121 admitted VLBW infants, 97 were analyzed, with 20 (20.6%; 95% confidence interval, 12.6-28.7) diagnosed with AKI. Among these, 50% had creatinine abnormalities, 30% had urinary output changes, and 20% had both. Severe AKI (stage 2 or 3) was observed in 30% of cases, none required dialysis. AKI was associated with higher SNAPPE-II (Score for Neonatal Acute Physiology with Perinatal Extension-II) scores, more frequent severe intraventricular hemorrhage, and an increased mortality rate (35%). Multivariate analysis identified AKI as an independent risk factor for mortality, with a 9.72-fold increased risk (95% confidence interval, 2.53-37.4; P