• Advances in Neonatal Acute Kidney Injury
    • Starr MC, Charlton JR, Guillet R, Reidy K, Tipple TE, Jetton JG, Kent AL, Abitbol CL, Ambalavanan N, Mhanna MJ, Askenazi DJ, Selewski DT, Harer MW; Neonatal Kidney Collaborative Board. Pediatrics. 2021 Nov;148(5):e2021051220
    • In this state-of-the-art review, we highlight the major advances over the last 5 years in neonatal acute kidney injury (AKI). Large multicenter studies reveal that neonatal AKI is common and independently associated with increased morbidity and mortality. The natural course of neonatal AKI, along with the risk factors, mitigation strategies, and the role of AKI on short- and long-term outcomes, is becoming clearer. Specific progress has been made in identifying potential preventive strategies for AKI, such as the use of caffeine in premature neonates, theophylline in neonates with hypoxic-ischemic encephalopathy, and nephrotoxic medication monitoring programs. 
    • doi: 10.1542/peds.2021-051220
  • Association of early dysnatremia with mortality in the neonatal intensive care unit: results from the AWAKEN study
    • Abby M Basalely, Russell Griffin, Katja M Gist, Ronnie Guillet, David J Askenazi, Jennifer R Charlton, David T Selewski, Mamta Fuloria, Frederick J Kaskel Kimberly J Reidy, AWAKEN Study Group. Journal of Perinatology. 2021
    • Dysnatremia developed in 50.2% of the cohort and was not associated with AKI. Mortality was associated with hyponatremia (HR 2.15, 95% CI 1.07-4.31), hypernatremia (HR 4.23, 95% CI 2.07-8.65), and combined hypo/hypernatremia (HR 6.39, 95% CI 2.01-14.01). In stratified models by AKI-status, hypernatremia and hypo/hypernatremia increased risk of mortality in neonates without AKI.
    • doi: 10.1038/s41372-021-01260-x
  • Low albumin levels are independently associated with neonatal acute kidney injury: a report from AWAKEN Study Group
    • Arwa Nada, David Askenazi, Juan C Kupferman, Maroun Mhanna, John D Mahan, Louis Boohaker, Linzi Li, Russell L Griffin. Pediatr Nephrol. 2021 Oct 18.
    • Low albumin levels were associated with increased odds of neonatal AKI; for every 0.1 g/dL decrease in albumin, the odds of late AKI increased by 12% on continuous analysis. After adjustment for potential confounders, neonates with albumin values in the lowest quartiles (< 2.2 g/dL) had an increased odds of early [Adjusted Odd Ratio (AdjOR) 2.5, 95% CI = 1.1-5.3, p < 0.03] and late AKI [AdjOR 13.4, 95% CI = 3.6-49.9, p < 0.0001] compared to those with albumin in the highest quartile (> 3.1 g/dL). Albumin levels of 2.6 g/dL and 2.4 g/dL best predicted early (AUC = 0.59) and late AKI (AUC = 0.64), respectively.
    • doi: 10.1007/s00467-021-05295-2
  • Relationship of patent ductus arteriosus management with neonatal AKI.
    • Guillet R, Selewski DT, Griffin R, Rastogi S, Askenazi DJ, D'Angio CT; Neonatal Kidney Collaborative. Journal of Perinatology volume 41, pages 1441–1447 (2021)
    • Of 526 neonates with sufficient data to diagnose AKI, 157 (30%) had PDA (61 conservative management, 62 pharmacologic treatment only, 34 surgical ligation). In analyses adjusted for sex, birthweight, gestational age, caffeine, nephrotoxin exposure, vasopressor and mechanical ventilation use, with conservative management as reference, there were no differences among treatment cohorts in the odds of AKI.
    • doi: 10.1038/s41372-021-01054-1