Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Sep 6, 2017; 6(5): 229-235
Published online Sep 6, 2017. doi: 10.5527/wjn.v6.i5.229
Prevalence and outcome of acute kidney injury, as defined by the new Kidney Disease Improving Global Outcomes guideline, in very low birth weight infants
Maisa Al Malla, Nisha Viji Varghese, Mustafa AlAbdullatif, Hassib Narchi, Mohammad Khassawneh
Maisa Al Malla, Nisha Viji Varghese, Mustafa AlAbdullatif, Mohammad Khassawneh, Department of Paediatrics, Tawam Hospital, P.O. Box 15258, Al Ain, United Arab Emirates
Hassib Narchi, Department of Paediatrics, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
Mohammad Khassawneh, Department of paediatrics, Jordan University of Science and Technology, Irbid 22110, Jordan
Author contributions: All authors contributed to this paper.
Institutional review board statement: The paper was reviewed by the Al Ain Medical District Human Research Ethics Committee.
Informed consent statement: Institutional review board did not request informed consent, as this is a chart review requires no interaction with patients, but all requirements protect patient confidentiality were fulfilled during data collection process.
Conflict-of-interest statement: None to declare.
Data sharing statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Maisa Al Malla, Specialist Physician, Neonatology Fellow, Department of Paediatrics, Tawam Hospital, P.O. Box 15258, Al Ain, United Arab Emirates. mmalla@seha.ae
Telephone: +971-55-4672493
Received: March 19, 2017
Peer-review started: March 20, 2017
First decision: May 8, 2017
Revised: July 12, 2017
Accepted: July 21, 2017
Article in press: July 23, 2017
Published online: September 6, 2017
Abstract
AIM

To evaluate the prevalence, risk factors and outcome of acute kidney injury (AKI) in very low birth weight (VLBW) infants.

METHODS

In this retrospective study of VLBW infants, we analyzed the prevalence of AKI, as defined by changes in serum creatinine and urine output, associated risk factors and outcomes.

RESULTS

A total of 293 VLBW infants (mean gestational age 28.7 wk) were included, of whom 109 weighed less than 1000 g at birth. The overall prevalence of AKI was 11.6% (22% in infants with a birth weight under 1000 g and 5.4% those heavier). A total of 19 (55%) affected infants died, with a mortality rate of 58% in infant less than 1000 g and 50% in those heavier. After adjusting for confounding variables, only necrotizing enterocolitis (NEC) remained associated with AKI, with odds ratio of 4.9 (95%CI: 1.9-18.6). Blood pressure and glomerular filtration rate (GFR) were not different between affected infants and the others upon discharge from hospital. A normal GFR was documented in all affected infants at one year of age.

CONCLUSION

Using Kidney Disease Improving Global Outcomes definition of AKI, it occurred in over 10% of VLBW infants, more commonly in infants with lower birth weight. NEC was an independent associated risk factor. Renal function, as defined by GFR, was normal in all surviving affected infants 10 to 12 mo later.

Keywords: Newborn, Case-control, Risk factors, Acute renal failure, Mortality, Kidney Disease Improving Global Outcomes

Core tip: Our study is the first study form United Arab Emirates, dealing with neonatal acute kidney injury (AKI); After using many different definition in reporting AKI in the past, Kidney Disease Improving Global Outcomes started a new definition trying to stage AKI into different stages; Retrospectively our study is using this definition and apply it to all infants admitted to our unite to identify the incidence and risk factors associated with AKI in different gestational age; Our study revealed that extreme premature babies are more susceptible to AKI and this disease is linked to other neonatal morbidities like Necrotizing Enter colitis, sepsis and can predict higher mortality.