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

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Abstract

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 < 90 ml/min/1.73m2 or chronic kidney disease (CKD). At ≥3 years of age, 5% (11 out of 222) had HTN.

Conclusion

At NICU discharge, infants with AKI stages 2 and 3 have a higher DBP than infants with stage 1 AKI and those who did not have AKI. However, there is no difference in the rate of HTN between the two groups. At ≥2 years ELBW infants are at risk for CKD independently of whether or not they develop neonatal AKI.

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Authors and Affiliations

  1. Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA

    Syeda Maqsood, Nicholas Fung, Vikas Chowdhary, Rupesh Raina & Maroun J. Mhanna

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  1. Syeda Maqsood
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  2. Nicholas Fung
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  3. Vikas Chowdhary
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  4. Rupesh Raina
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  5. Maroun J. Mhanna
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Correspondence to Maroun J. Mhanna.

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Maqsood, S., Fung, N., Chowdhary, V. et al. Outcome of extremely low birth weight infants with a history of neonatal acute kidney injury. Pediatr Nephrol 32, 1035–1043 (2017). https://doi.org/10.1007/s00467-017-3582-y

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  • DOI: https://doi.org/10.1007/s00467-017-3582-y

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