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Objective <p>Determine whether acute kidney injury (AKI) is associated with subsequent late-onset infection (LOI) among extremely low gestational age newborns (ELGAN).</p> Study design <p>Secondary analysis of participants in the Preterm Erythropoietin for Neuroprotection Trial. Infants surviving ≥7 days with sufficient serum creatinine data were included. The primary outcome was any LOI, starting ≥72 h after AKI. Time-varying Cox proportional hazards modeling estimated adjusted hazard ratios of AKI and LOI.</p> Results <p>332/872 (38%) study infants experienced AKI. 552/872 (63%) experienced LOI. 336/552 (60.9%) of late-onset infections were culture-positive, and 216/552 (39.1%) were culture-negative. After adjusting for gestational age, sex, postnatal steroids, vancomycin/gentamicin receipt ≥72 h, birthweight, and 5-min APGAR, any AKI was associated with 1.47x increased hazard of subsequent LOI (adjusted HR: 1.47; 95% CI: 1.15–1.87).</p> Conclusion <p>Prior AKI increased hazard of subsequent LOI in a large cohort of ELGANs. Clinicians may anticipate higher risk of infectious complications after AKI.</p>

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Acute kidney injury and subsequent risk of late-onset infection among extremely low gestational age newborns

  • 期刊论文

  • 发表日期：

    2025年9月11日

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  • Megan J. Turner,
  • Russell Griffin,
  • Meredith Schuh,
  • Keia Sanderson,
  • Cara Slagle,
  • Shina Menon,
  • David Askenazi,
  • Katja Gist

摘要

Objective

Determine whether acute kidney injury (AKI) is associated with subsequent late-onset infection (LOI) among extremely low gestational age newborns (ELGAN).

Study design

Secondary analysis of participants in the Preterm Erythropoietin for Neuroprotection Trial. Infants surviving ≥7 days with sufficient serum creatinine data were included. The primary outcome was any LOI, starting ≥72 h after AKI. Time-varying Cox proportional hazards modeling estimated adjusted hazard ratios of AKI and LOI.

Results

332/872 (38%) study infants experienced AKI. 552/872 (63%) experienced LOI. 336/552 (60.9%) of late-onset infections were culture-positive, and 216/552 (39.1%) were culture-negative. After adjusting for gestational age, sex, postnatal steroids, vancomycin/gentamicin receipt ≥72 h, birthweight, and 5-min APGAR, any AKI was associated with 1.47x increased hazard of subsequent LOI (adjusted HR: 1.47; 95% CI: 1.15–1.87).

Conclusion

Prior AKI increased hazard of subsequent LOI in a large cohort of ELGANs. Clinicians may anticipate higher risk of infectious complications after AKI.