Hailey W Gavigan1, Cara L Slagle2, Kelli A Krallman3, Brenda B Poindexter2, David K Hooper3, Stuart L Goldstein3. 1. Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Hailey.Gavigan@atriumhealth.org. 2. Divison of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 3. Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Abstract
BACKGROUND: Previous studies in non-critically ill hospitalized pediatric patients have shown that daily serum creatinine monitoring for the development of nephrotoxic medication-associated acute kidney injury decreases both the rate of high nephrotoxic medication exposure and associated acute kidney injury. Attempts to spread this successful screening program have been met with concerns that daily serum creatinine monitoring in critically ill neonates with high-risk nephrotoxic medication exposure would lead to iatrogenic anemia and an increase in blood transfusion requirements. METHODS: We measured blood transfusion rates while implementing a system of daily serum creatinine monitoring in critically ill neonates at risk for high nephrotoxic medication-associated acute kidney injury. RESULTS: There was no correlation between blood transfusion rates and serum creatinine monitoring rates. CONCLUSIONS: We recommend that critically ill neonates identified as having high-risk nephrotoxic medication exposure undergo daily screening for the development of nephrotoxic medication-associated acute kidney injury.
BACKGROUND: Previous studies in non-critically ill hospitalized pediatric patients have shown that daily serum creatinine monitoring for the development of nephrotoxic medication-associated acute kidney injury decreases both the rate of high nephrotoxic medication exposure and associated acute kidney injury. Attempts to spread this successful screening program have been met with concerns that daily serum creatinine monitoring in critically ill neonates with high-risk nephrotoxic medication exposure would lead to iatrogenic anemia and an increase in blood transfusion requirements. METHODS: We measured blood transfusion rates while implementing a system of daily serum creatinine monitoring in critically ill neonates at risk for high nephrotoxic medication-associated acute kidney injury. RESULTS: There was no correlation between blood transfusion rates and serum creatinine monitoring rates. CONCLUSIONS: We recommend that critically ill neonates identified as having high-risk nephrotoxic medication exposure undergo daily screening for the development of nephrotoxic medication-associated acute kidney injury.
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