• Perinatal risk factors associated with acute kidney injury severity and duration among infants born extremely preterm
    • Keia Sanderson, Russell Griffin, Nekayla Anderson, Andrew M South, Jonathan R Swanson, Michael Zappitelli, Heidi J Steflik, Marissa J DeFreitas, Jennifer Charlton, David Askenazi; Neonatal Kidney Collaborative (NKC) Research Committee
    • Of 923 participants, 2% had early severe AKI. In the adjusted model, gestational diabetes (adjusted HR (aHR) 5.4, 95% CI 1.1-25.8), non-steroidal anti-inflammatory drugs (NSAIDs) (aHR 3.2, 95% CI 1.0-9.8), and vancomycin (aHR 13.9, 95% CI 2.3-45.1) were associated with early severe AKI. Late severe AKI occurred in 22% of participants. Early severe AKI (aHR 2.5, 95% CI 1.1-5.4), sepsis (aHR 2.5, 95% CI 1.4-4.4), vasopressors (aHR 2.9, 95% CI 1.8-4.6), and diuretics (aHR 2.6, 95% CI 1.9-3.6) were associated with late severe AKI. Participants who had necrotizing enterocolitis or received NSAIDs had longer severe AKI duration.
    • doi: 10.1038/s41390-024-03102-w
  • Incidence, Risk Factors, and Outcomes Associated With Recurrent Neonatal Acute Kidney Injury in the AWAKEN Study
    • Austin D Rutledge, Russell L Griffin, Katherine Vincent, David J Askenazi, Jeffrey L Segar, Juan C Kupferman, Shantanu Rastogi, David T Selewski, Heidi J Steflik; Neonatal Kidney Collaborative. JAMA Netw Open 2024 Feb 5;7(2):e2355307.
    • The study cohort (n = 2162) included 1233 male neonates (57.0%). Gestational age distribution was less than 29 weeks for 276 neonates (12.8%), 29 to less than 36 weeks for 958 (44.3%), and 36 weeks or older for 928 (42.9%). Of 605 neonates with AKI, 133 (22.0%) developed rAKI with risk factors including younger gestational age, lower birthweight, and higher stage of initial AKI. Infants with rAKI experienced longer median LOS (no AKI, 17 [IQR, 8-34] days; sAKI, 18 [IQR, 9-45] days; rAKI, 60 [IQR, 25-109] days; P < .001). Time-varying Cox proportional hazards regression models suggest rAKI is independently associated with a lower hazard of discharge (adjusted hazard ratio, 0.7 [95% CI, 0.6-0.9]; P = .01) when compared with sAKI, but mortality did not differ between groups (adjusted hazard ratio, 1.4 [95% CI, 0.6-3.0]; P = .44).
    • doi: 10.1001/jamanetworkopen.2023.55307