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, 28(3), , pp.116-123
• Main Authors: Pasini, Laís Fagundes, Kuchart, Léia de Lima, Bilibio, Sarah Assoni, Catarina, Roberta Florian Santa, Araújo, Breno Fauth de, Selistre, Luciano da Silva, de Souza, Vandréa C.
• Format: Article
• Language: English
• Subjects: acute kidney injury; infant mortality; infant, premature; intensive care, neonatal; 소아과학
• ISSN: 2384-0242; 2384-0250
• DOI: 10.3339/ckd.24.012

Purpose: 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, this study will examine 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