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Risk factors for acute kidney injury in very-low birth weight newborns: a systematic review with meta-analysis

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Abstract

This study aims to analyze the main risk factors for acute kidney injury in the subgroup of very-low birth weight newborns, using the diagnosing criteria of the Kidney Disease Improving Global Outcomes (KDIGO) or the Acute Kidney Injury Network (AKIN). A systematic review of the literature was performed on the EMBASE® and PubMed® platforms. Studies that evaluated the risk factors for developing AKI in VLBW newborns were included. For the meta-analysis, we only included the risk factors that were associated with AKI in the univariate analysis of at least two studies. After an initial screening, abstract readings, and full-text readings, 10 articles were included in the systematic review and 9 in the meta-analysis. The incidence of AKI varied from 11.6 to 55.8%. All the studies have performed multivariate analysis, and the risk factors that appeared most were PDA and hemodynamic instability (use of inotropes or hypotension), sepsis, and invasive mechanical ventilation. After the meta-analysis, only cesarian delivery did not show an increased risk of AKI, all the other variables remained as important risk factors. Moreover, in our meta-analysis, we found a pooled increased risk of death in newborns with AKI almost 7 times.

 Conclusion: AKI in VLBW has several risk factors and must be seen as a multifactorial disease. The most common risk factors were PDA, hemodynamic instability, sepsis, and invasive mechanical ventilation.

What is known:

• Acute kidney injury is associated with worst outcomes in all ages. It´s prevention can help diminish mortality.

What is new:

• A synthesis of the main risk factors associated with AKI in very low birth weight newborns.

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Data availability

No datasets were generated or analyzed during the current study.

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Funding

No funds, grants, or other support was received by the authors.

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, University of São Paulo, Instituto da Criança e do Adolescente do Hospital das Clínicas, Av. Dr. Enéas de Carvalho Aguiar, 647, São Paulo, 05403-000, SP, Brazil

    Lucas Hirano Arruda Moraes, Vera Lúcia Jornada Krebs & Werther Brunow de Carvalho

  2. Neonatal Section, Pediatric Division, University Hospital of the University of São Paulo, São Paulo, Brazil

    Lucas Hirano Arruda Moraes

Authors
  1. Lucas Hirano Arruda Moraes
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  2. Vera Lúcia Jornada Krebs
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  3. Werther Brunow de Carvalho
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Contributions

All authors contributed to the study conception and design. L.H.A.M. and V.L.J.K. were responsible for reviewing the articles, for data collection and analyzes. Prof. W.B.C. was responsible for advising in case of disagreement between the other authors during the selection of articles and data extraction. All the authors contributed to the preparation and review of the manuscript.

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Correspondence to Lucas Hirano Arruda Moraes.

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Communicated by Daniele De Luca

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Hirano Arruda Moraes, L., Jornada Krebs, V.L. & de Carvalho, W.B. Risk factors for acute kidney injury in very-low birth weight newborns: a systematic review with meta-analysis. Eur J Pediatr (2024). https://doi.org/10.1007/s00431-024-05593-5

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  • DOI: https://doi.org/10.1007/s00431-024-05593-5

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