ESPN 54th Annual Meeting

ESPN 2022


 
Acute Kidney Injury in Extremely and Very Low Birth Weight Infants
SANDRA HABBIG 1 KATHRIN BURGMAIER 1 MELANIE ZEIHER 1 ANNA WEBER 1 KATRIN MEHLER 2 ANGELA KRIBS 2

1- UNIVERSITY OF COLOGNE, FACULTY OF MEDICINE AND UNIVERSITY HOSPITAL COLOGNE, DEPARTMENT OF PEDIATRICS, PEDIATRIC NEPHROLOGY, COLOGNE, GERMANY
2- UNIVERSITY OF COLOGNE, FACULTY OF MEDICINE AND UNIVERSITY HOSPITAL COLOGNE, DEPARTMENT OF PEDIATRICS, NEONATOLOGY, COLOGNE, GERMANY
 
Introduction:

Acute kidney injury (AKI) in preterm infants has gained enormous attention in recent years as multi-center studies revealed a prevalence of AKI of up to 50 % in these infants and identified AKI as an independent risk factor for mortality.

Material and methods:

We here present a retrospective analysis of extremely-low-birth-weight (ELBW, birth weight < 1000 g) and very-low-birth-weight (VLBW, birthweight 1000-1499 g) infants born in our tertiary center in 2020. We applied the most recent KDIGO definition for neonatal AKI to identify AKI in this cohort. 

Results:

This study includes 128 preterm infants (68 ELBW and 60 VLBW) with a median birthweight of 962 (range 210-1490) g. Of the entire cohort, 25 patients  (20%) suffered from at least one episode of neonatal AKI, in eight patients (6% of the whole cohort) AKI was classified as severe (stage 2 or 3). The incidence of AKI differed significantly between ELBW and VLBW infants (28 versus 10%, p=0.011). Both, length of intensive care as well as length of hospitalisation, was significantly longer in the infants with AKI as compared to those without AKI.

Infants with AKI had significantly lower Apgar Scores at 10 minutes compared to infants without AKI. Mechanical ventilation and therapy with resuscitation drugs was performed more frequently in the cohort with AKI (68% vs. 21%; p<0.001; 40% vs. 11%; p< 0.001). In addition, more infants with AKI received indomethacin due to persisting ductus arteriosus Botalli.

Conclusions:

As already shown in other studies, neonatal AKI occurred more frequently in ELBW as compared to VLBW infants. Infants with AKI had a lower gestational age and birth weight, lower APGAR values and needed a less intensive therapy including nephrotoxic medication. Interestingly, the overall incidence of AKI was substantially lower in our cohort as compared to recent studies which might be related to the very restrictive use of intubation and mechanical ventilation in our center.