J Bryan Carmody1, Matthew W Harer2, Anna R Denotti3, Jonathan R Swanson2, Jennifer R Charlton4. 1. Division of Nephrology, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA. 2. Division of Neonatology, Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, VA. 3. Department of Pediatrics, Ospedale Regionale per le Microcitemie, University of Cagliari, Cagliari, Italy. 4. Division of Nephrology, Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, VA. Electronic address: jrc6n@virginia.edu.
Abstract
OBJECTIVE: To evaluate the association between caffeine exposure and acute kidney injury (AKI) in very low birth weight (VLBW; ≤1500 g) neonates. STUDY DESIGN: We retrospectively reviewed a cohort of 140 VLBW neonates consecutively admitted to the University of Virginia's neonatal intensive care unit from March 2011 to June 2012, excluding only those admitted >2 days of age or who died at <2 days after birth. We separately analyzed a subgroup of 44 neonates who received prolonged invasive respiratory support (mechanical ventilation for first 7 days after birth). The exposure of interest was caffeine exposure in the first week after birth. The primary outcome was AKI within the first 10 days after birth according to the Kidney Disease: Improving Global Outcomes system, modified to include only serum creatinine. RESULTS: Caffeine exposure occurred in 72.1% of all patients and 54.5% of those who received prolonged invasive respiratory support. AKI occurred less frequently in neonates who received caffeine (all patients: 17.8% vs 43.6%; P = .002; prolonged invasive respiratory support: 29.2% vs 75.0%; P = .002). Caffeine exposure was associated with decreased odds for AKI in logistic regression models adjusted for sex, birth weight, gestational age, small for gestational age status, illness severity on admission, and receipt of indomethacin, invasive ventilation, dopamine, aminoglycosides, and vancomycin (all patients: OR 0.22; 95% CI 0.07-0.75, P = .02; prolonged invasive respiratory support subgroup: OR 0.06; 95% CI 0.01-0.57, P = .02). CONCLUSIONS: In a cohort of VLBW neonates, those exposed to caffeine were less likely to experience AKI.
OBJECTIVE: To evaluate the association between caffeine exposure and acute kidney injury (AKI) in very low birth weight (VLBW; ≤1500 g) neonates. STUDY DESIGN: We retrospectively reviewed a cohort of 140 VLBW neonates consecutively admitted to the University of Virginia's neonatal intensive care unit from March 2011 to June 2012, excluding only those admitted >2 days of age or who died at <2 days after birth. We separately analyzed a subgroup of 44 neonates who received prolonged invasive respiratory support (mechanical ventilation for first 7 days after birth). The exposure of interest was caffeine exposure in the first week after birth. The primary outcome was AKI within the first 10 days after birth according to the Kidney Disease: Improving Global Outcomes system, modified to include only serum creatinine. RESULTS:Caffeine exposure occurred in 72.1% of all patients and 54.5% of those who received prolonged invasive respiratory support. AKI occurred less frequently in neonates who received caffeine (all patients: 17.8% vs 43.6%; P = .002; prolonged invasive respiratory support: 29.2% vs 75.0%; P = .002). Caffeine exposure was associated with decreased odds for AKI in logistic regression models adjusted for sex, birth weight, gestational age, small for gestational age status, illness severity on admission, and receipt of indomethacin, invasive ventilation, dopamine, aminoglycosides, and vancomycin (all patients: OR 0.22; 95% CI 0.07-0.75, P = .02; prolonged invasive respiratory support subgroup: OR 0.06; 95% CI 0.01-0.57, P = .02). CONCLUSIONS: In a cohort of VLBW neonates, those exposed to caffeine were less likely to experience AKI.
Authors: J E Constance; D Reith; R M Ward; A Balch; C Stockmann; E K Korgenski; E A Thorell; C M T Sherwin Journal: J Perinatol Date: 2017-06-08 Impact factor: 2.521
Authors: Matthew W Harer; David J Askenazi; Louis J Boohaker; J Bryan Carmody; Russell L Griffin; Ronnie Guillet; David T Selewski; Jonathan R Swanson; Jennifer R Charlton Journal: JAMA Pediatr Date: 2018-06-04 Impact factor: 16.193
Authors: Jennifer R Charlton; Louis Boohaker; David Askenazi; Patrick D Brophy; Carl D'Angio; Mamta Fuloria; Jason Gien; Russell Griffin; Sangeeta Hingorani; Susan Ingraham; Ayesa Mian; Robin K Ohls; Shantanu Rastogi; Christopher J Rhee; Mary Revenis; Subrata Sarkar; Alexandra Smith; Michelle Starr; Alison L Kent Journal: Clin J Am Soc Nephrol Date: 2019-01-31 Impact factor: 8.237