Outcome of extremely low birth weight infants with a history of neonatal acute kidney injury

• Published in: Pediatric nephrology (Berlin, West) West), 2017-06, Vol.32 (6), p.1035-1043
• Main Authors: Maqsood, Syeda, Fung, Nicholas, Chowdhary, Vikas, Raina, Rupesh, Mhanna, Maroun J.
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - complications; Acute Kidney Injury - epidemiology; Age; Age Factors; Birth weight; Blood pressure; Blood Pressure Determination; Case-Control Studies; Child; Child, Preschool; Creatinine; Creatinine - blood; Female; Follow-Up Studies; Hospitalization; Humans; Hypertension; Hypertension - blood; Hypertension - epidemiology; Hypertension - etiology; Incidence; Infant; Infant, Extremely Low Birth Weight; Infant, Newborn; Intensive Care Units, Neonatal - statistics & numerical data; Kidney diseases; Length of Stay; Male; Medical records; Medicine; Medicine & Public Health; Mortality; Nephrology; Original Article; Patient Discharge; Pediatrics; Premature birth; Prevalence; Retrospective Studies; Urology
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-017-3582-y

Objective To study the outcome of extremely low birth weight (ELBW) infants with a history of acute kidney injury (AKI). Method In a retrospective, case control study, medical records of all ELBW infants admitted to the neonatal intensive care unit (NICU) between Jan 2002 and Dec 2011 were reviewed. Medical records were reviewed for infants’ demographics, blood pressure (BP) at NICU discharge and at ≥3 years, and estimated glomerular filtration rate (eGFR) at ≥2 years. Results During the study period, 222 patients met the inclusion criteria, of whom 10% (23 out of 222) had AKI stage 2 and 3, 39% (87 out of 222) had AKI stage 1, and the rest did not have AKI. At NICU discharge, there was a difference in diastolic BP (DBP) among infants who had AKI stages 2 and 3, those who had stage 1, and those who did not have AKI (53 ± 12 vs 46 ± 9 vs 46 ± 11 mmHg respectively; p  = 0.007), and 11% (23 out of 209) had hypertension (HTN). Although there was a significant correlation between the rise in SCr and DBP at NICU discharge in infants with AKI (R = 0.304; p  = 0.004), there was no difference in HTN between infants with and those without AKI. At ≥2 years of age, 4% (5 out of 120) across all groups had an eGFR