David J Askenazi1,2, Patrick J Heagerty3, Robert H Schmicker3, Russell Griffin4, Patrick Brophy5, Sandra E Juul6, Dennis E Mayock6, Stuart L Goldstein7, Sangeeta Hingorani6. 1. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA. daskenazi@peds.uab.edu. 2. , Birmingham, USA. daskenazi@peds.uab.edu. 3. Department of Biostatistics, University of Washington, Seattle, WA, USA. 4. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. 5. University of Rochester/Golisano Children's Hospital, Rochester, NY, USA. 6. Department of Pediatrics, University of Washington/Seattle Children's Hospital, Seattle, WA, USA. 7. Department of Pediatrics, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA.
Abstract
BACKGROUND: To determine the prevalence and severity of acute kidney injury (AKI) at different time frames in relation to gestational age (GA) and birthweight (BW) in extremely low gestational age neonates (ELGAN). Our hypothesis is that ELGAN with lower GA and lower BW have higher AKI rates. METHODS: A total of 923 ELGAN enrolled in the Preterm Erythropoietin Neuroprotection Trial were evaluated from birth until death or hospital discharge. AKI was defined according to kidney disease: improving global outcomes (KDIGO) definition from clinically-derived serum creatinine (SCr) measurements. Severe AKI was defined as stage 2 or higher. RESULTS: For the entire cohort, 351/923 (38.0%, CI = 34.8-41.3%) had at least one episode of stage 1 or higher AKI and 168/923 (18.2%, CI = 15.7-20.7%) had at least one episode of severe (stage 2 or higher) AKI. The prevalence of AKI stage 1 or higher for the entire cohort during the early (days 3-7), middle (days 8-14), and late follow-up period (after day 14) was 112/923 (12.1%, CI = 10.0-14.3%), 142/891 (15.9%, CI = 13.5-18.4%), and 249/875 (28.5%, CI = 25.4-31.5%), respectively. The rates of severe AKI during the hospital course were 27.8%, 21.9%, 13.6%, and 9.4% for the 24-, 25-, 26-, and 27-week GA groups, respectively. AKI rates were significantly higher with decreasing GA and decreasing BW for stated time trends (all p < 0.01 using tests for trend). CONCLUSIONS: AKI is relatively common in ELGAN during their initial hospital course and is associated with lower GA and BW.
BACKGROUND: To determine the prevalence and severity of acute kidney injury (AKI) at different time frames in relation to gestational age (GA) and birthweight (BW) in extremely low gestational age neonates (ELGAN). Our hypothesis is that ELGAN with lower GA and lower BW have higher AKI rates. METHODS: A total of 923 ELGAN enrolled in the Preterm Erythropoietin Neuroprotection Trial were evaluated from birth until death or hospital discharge. AKI was defined according to kidney disease: improving global outcomes (KDIGO) definition from clinically-derived serum creatinine (SCr) measurements. Severe AKI was defined as stage 2 or higher. RESULTS: For the entire cohort, 351/923 (38.0%, CI = 34.8-41.3%) had at least one episode of stage 1 or higher AKI and 168/923 (18.2%, CI = 15.7-20.7%) had at least one episode of severe (stage 2 or higher) AKI. The prevalence of AKI stage 1 or higher for the entire cohort during the early (days 3-7), middle (days 8-14), and late follow-up period (after day 14) was 112/923 (12.1%, CI = 10.0-14.3%), 142/891 (15.9%, CI = 13.5-18.4%), and 249/875 (28.5%, CI = 25.4-31.5%), respectively. The rates of severe AKI during the hospital course were 27.8%, 21.9%, 13.6%, and 9.4% for the 24-, 25-, 26-, and 27-week GA groups, respectively. AKI rates were significantly higher with decreasing GA and decreasing BW for stated time trends (all p < 0.01 using tests for trend). CONCLUSIONS: AKI is relatively common in ELGAN during their initial hospital course and is associated with lower GA and BW.
Authors: Keia R Sanderson; Bradley Warady; William Carey; Veeral Tolia; Marcella H Boynton; Daniel K Benjamin; Wesley Jackson; Matthew Laughon; Reese H Clark; Rachel G Greenberg Journal: J Pediatr Date: 2021-11-16 Impact factor: 4.406
Authors: Sangeeta Hingorani; Robert Schmicker; Kaashif A Ahmad; Ivan D Frantz; Dennis E Mayock; Edmund F La Gamma; Mariana Baserga; Janine Y Khan; Maureen M Gilmore; Tonya Robinson; Patrick Brophy; Patrick J Heagerty; Sandra E Juul; Stuart Goldstein; David Askenazi Journal: Clin J Am Soc Nephrol Date: 2022-07-19 Impact factor: 10.614
Authors: Aurélie De Mul; Paloma Parvex; Alice Héneau; Valérie Biran; Antoine Poncet; Olivier Baud; Marie Saint-Faust; Alexandra Wilhelm-Bals Journal: Clin J Am Soc Nephrol Date: 2022-06-28 Impact factor: 10.614
Authors: David J Askenazi; Patrick J Heagerty; Robert H Schmicker; Patrick Brophy; Sandra E Juul; Stuart L Goldstein; Sangeeta Hingorani Journal: J Pediatr Date: 2021-01-20 Impact factor: 4.406
Authors: David J Askenazi; Brian A Halloran; Patrick J Heagerty; Robert H Schmicker; Patrick Brophy; Sandra E Juul; Sangeeta Hingorani; Stuart L Goldstein Journal: Pediatr Res Date: 2021-11-30 Impact factor: 3.953
Authors: Sangeeta Hingorani; Robert H Schmicker; Patrick D Brophy; Patrick J Heagerty; Sandra E Juul; Stuart L Goldstein; David Askenazi Journal: Clin J Am Soc Nephrol Date: 2021-06-11 Impact factor: 10.614