Risk factors of acute kidney injury in very low birth weight infants in a tertiary neonatal intensive care unit.

Autor:	Moraes LHA; Faculdade de Medicina da Universidade de São Paulo, Departamento de Pediatria, Instituto da Criança e do Adolescente do Hospital das Clínicas, São Paulo, SP, Brazil. Electronic address: lucas.hirano.moraes@hu.usp.br., Krebs VLJ; Faculdade de Medicina da Universidade de São Paulo, Departamento de Pediatria, Instituto da Criança e do Adolescente do Hospital das Clínicas, São Paulo, SP, Brazil., Koch VHK; Faculdade de Medicina da Universidade de São Paulo, Departamento de Pediatria, Instituto da Criança e do Adolescente do Hospital das Clínicas, São Paulo, SP, Brazil., Magalhães NAM; Faculdade de Medicina da Universidade de São Paulo, Departamento de Pediatria, Instituto da Criança e do Adolescente do Hospital das Clínicas, São Paulo, SP, Brazil., de Carvalho WB; Faculdade de Medicina da Universidade de São Paulo, Departamento de Pediatria, Instituto da Criança e do Adolescente do Hospital das Clínicas, São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Jornal de pediatria [J Pediatr (Rio J)] 2023 May-Jun; Vol. 99 (3), pp. 235-240. Date of Electronic Publication: 2022 Dec 06.
DOI:	10.1016/j.jped.2022.11.001
Abstrakt:	Objective: Acute kidney injury (AKI) in the neonatal period is associated with worst outcomes as increased mortality and increased length of hospital stay. Very low birth weight (VLBW) newborns are at higher risk for developing several other conditions that are associated with worst outcomes. Understanding the risk factors for AKI may help to prevent this condition and improve neonatal care for this population. Methods: This retrospective cohort study included 155 very low birth weight newborns admitted between 2015 and 2017. The authors compared the newborns who developed neonatal AKI with the non-AKI group and analyzed the main risk factors for developing AKI in the population. The authors also performed an analysis of the main outcomes defined as the duration of mechanical ventilation, length of stay, and death. Results: From the cohort, a total of 61 (39.4%) patients had AKI. The main risk factors associated with Neonatal AKI were necrotizing enterocolitis (aOR 7.61 [1.69 - 34.37]; p = 0.008), neonatal sepsis (aOR 2.91 [1.17 - 7.24], p = 0.021), and hemodynamic instability (aOR 2.99 [1.35 - 6.64]; p = 0.007). Neonatal AKI was also associated with an increase in the duration of mechanical ventilation in 9.4 days (p = 0.026) and in an increase in mortality 4 times (p = 0.009), after adjusting for the other variables. Conclusion: The present results highlight the importance of minimizing sepsis and necrotizing enterocolitis, as well as the importance of identifying hemodynamic instability, to prevent AKI and diminish the burden of morbimortality in VLBW newborns. Competing Interests: Conflicts of interest The authors declare no conflicts of interest. (Copyright © 2022 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)
Databáze:	MEDLINE
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