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Background <p>Neonatal acute kidney injury (AKI) is common in infants born extremely preterm (EPT, &lt; 28&#xa0;weeks’ gestation). Neonatal AKI is independently associated with increased mortality and is likely to be associated with kidney dysfunction later in life. This study aimed to describe the epidemiology of AKI in EPT infants in a single tertiary neonatal centre.</p> Methods <p>Retrospective study of EPT infants admitted to a tertiary neonatal centre in Australia between August 2020 and December 2022. AKI was defined using the Kidney Disease Improving Global Outcomes (KDIGO) definition (including creatinine and oliguria criteria). Comparisons between AKI and non-AKI cohorts used linear, logistic, or quantile regression.</p> Results <p>Of 204 infants admitted during the study period, 193 were included in the study (11 excluded due to death or medical transfer within 48&#xa0;h after birth). Sixty infants (31%) had an episode of AKI during their inpatient admission: 31 (51.7%) had AKI stage 1, 11 (18.3%) had stage 2, and 18 (30%) had stage 3. Among these, 27 (45%) were recognised by the treating team, 18 (30%) had the diagnosis documented on their discharge summary, and three (5%) were referred for nephrology follow-up. Compared with the non-AKI cohort, infants with AKI were of lower gestational age and lower birth weight and had greater exposure to nephrotoxic medication. Infants with AKI had more episodes of sepsis, more days on respiratory support, and more days admitted to a tertiary centre than those without AKI.</p> Conclusions <p>AKI in EPT infants is common and associates with multiple comorbidities and treatments in the NICU. These data highlight risk factors on which AKI screening and stewardship programmes can be focused.</p> Graphical abstract <p></p>

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Acute kidney injury in extremely preterm infants: findings from an Australian single-centre retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年12月20日

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  • Jane B. McMahon,
  • Nikki Petrakis,
  • Jeanie L. Y. Cheong,
  • Thomas A. Forbes,
  • Kate A. Hodgson

摘要

Background

Neonatal acute kidney injury (AKI) is common in infants born extremely preterm (EPT, < 28 weeks’ gestation). Neonatal AKI is independently associated with increased mortality and is likely to be associated with kidney dysfunction later in life. This study aimed to describe the epidemiology of AKI in EPT infants in a single tertiary neonatal centre.

Methods

Retrospective study of EPT infants admitted to a tertiary neonatal centre in Australia between August 2020 and December 2022. AKI was defined using the Kidney Disease Improving Global Outcomes (KDIGO) definition (including creatinine and oliguria criteria). Comparisons between AKI and non-AKI cohorts used linear, logistic, or quantile regression.

Results

Of 204 infants admitted during the study period, 193 were included in the study (11 excluded due to death or medical transfer within 48 h after birth). Sixty infants (31%) had an episode of AKI during their inpatient admission: 31 (51.7%) had AKI stage 1, 11 (18.3%) had stage 2, and 18 (30%) had stage 3. Among these, 27 (45%) were recognised by the treating team, 18 (30%) had the diagnosis documented on their discharge summary, and three (5%) were referred for nephrology follow-up. Compared with the non-AKI cohort, infants with AKI were of lower gestational age and lower birth weight and had greater exposure to nephrotoxic medication. Infants with AKI had more episodes of sepsis, more days on respiratory support, and more days admitted to a tertiary centre than those without AKI.

Conclusions

AKI in EPT infants is common and associates with multiple comorbidities and treatments in the NICU. These data highlight risk factors on which AKI screening and stewardship programmes can be focused.

Graphical abstract