Diagnosis and Risk Factors of Acute Kidney Injury in Very Low Birth Weight Infants
| Autor: | Cassandra Arevalo, Fredrick Dapaah-Siakwan, Sharina Rajbhandari, Ankana Daga, Agnes Salvador |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Birth weight Population 030232 urology & nephrology Infant Premature Diseases urologic and male genital diseases Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Risk Factors 030225 pediatrics medicine Humans Infant Very Low Birth Weight Pediatrics Perinatology and Child Health pRIFLE Risk factor education Intensive care medicine Retrospective Studies education.field_of_study Respiratory distress business.industry Incidence Infant Newborn Acute kidney injury lcsh:RJ1-570 Reproducibility of Results Gestational age AKIN lcsh:Pediatrics medicine.disease Confidence interval female genital diseases and pregnancy complications Low birth weight acute kidney injury Pediatrics Perinatology and Child Health Female very low birth weight infants medicine.symptom business preterm Infant Premature |
| Zdroj: | Pediatrics and Neonatology, Vol 58, Iss 3, Pp 258-263 (2017) |
| ISSN: | 1875-9572 |
| Popis: | BackgroundAcute kidney injury (AKI) is common in critically ill premature infants. There is a lack of consensus on the diagnostic definition of AKI in very low birth weight (VLBW) infants. The primary aim of this study was to determine the incidence and risk factors for AKI in VLBW infants using the AKI network (AKIN) and pRIFLE (pediatric Risk, Injury, Failure, Loss, End-Stage) criteria and to evaluate whether Clinical Risk Index for Babies (CRIB II) score is a predictor of AKI. The secondary objective was to determine the extent of agreement between the AKIN and pRIFLE criteria in the diagnosis of AKI in VLBW infants.MethodsThis was a retrospective chart review of 115 VLBW (< 1500 g) infants born in an academic center with a Level 3B neonatal intensive care unit. Multiple congenital anomalies, transfer to other centers, or death within the first 2 weeks were the exclusion criteria. Relevant data were collected and analyzed in the first 2 weeks postnatally.ResultsAKI incidence, according to AKIN and pRIFLE criteria, was 20.1% and 22.6%, respectively. As per the interrater reliability analysis, there was a fair agreement between the two criteria (kappa = 0.217). AKI was nonoliguric. The length of stay was significantly longer in the AKI group. Prenatal nonsteroidal anti-inflammatory drug exposure, lower gestational age, lower birth weight, respiratory distress syndrome, mechanical ventilation, patent ductus arteriosus, hypotension, late onset sepsis, and higher CRIB II scores were significantly associated with AKI. Our regression analysis found CRIB II scores to be an independent risk factor for AKI (odds ratio = 1.621; 95% confidence interval, 1.230–2.167; p = 0.001).ConclusionThe determination of AKI using the pRIFLE and AKIN criteria yielded different results. pRIFLE appears to be more sensitive in VLBW infants. A high CRIB II score was recorded for AKI. Future studies are necessary to develop a uniform definition and identify the risk factors to improve the outcomes in this population. |
| Databáze: | OpenAIRE |
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