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Early caffeine citrate administration linked to reduced acute kidney injury risk in preterm neonates
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According to a recently published study, caffeine administration in preterm neonates was associated with reduced incidence and severity of acute kidney injury.
Acute kidney injury is common among preterm neonates and is associated with increased morbidity and mortality; however, injury occurred less frequently among neonates who received caffeine administration than those who did not.
Between October 2016 and December 2017, researchers examine data from 675 neonates born between January 1 and March 31, 2014 as part of a retrospective, international multicenter cohort study called AWAKEN. The analysis revealed that 30% of neonates admitted to an intensive care unit developed acute kidney injury and had almost 5 times higher adjusted odds for mortality compared with neonates without acute kidney injury.
According to the investigators, 447 neonates received at least one dose of caffeine during the first 7 days after birth and before AKI. Regarding the 228 neonates considered to have not received caffeine, 199 received no caffeine during the first 7 days after birth, whereas 29 received caffeine only after AKI. Further, 249 of the 675 received their first dose of caffeine on day 1 after birth, and 363 of 675 received their first dose within the first 2 days after birth.
Investigators noted that, while caffeine administration in the first 7 days after birth may correlate with less frequent acute kidney injury in preterm neonates, further studies on dosage, timing of administration, and long-term outcomes are required.
"In this large multicenter, retrospective study, we found that only 4 neonates needed to be treated with caffeine to prevent one-episode acute kidney injury. Surprising to our group, the caffeine-treated neonates were the ‘sicker’ group yet still had a lower rate of AKI. We also saw a reduction of AKI which extended to the very preterm group (including 28- to 32-week neonates), a population that does not routinely receive caffeine,” Jennifer R. Charlton, MD, MSc, University of Virginia, department of pediatrics, division of nephrology, and senior author of the study, told Healio Nephrology. “This study highlights the need for a prospective study to determine if caffeine can prevent AKI and more importantly, if caffeine could have a role in reducing the longer-term burden of chronic kidney disease in this vulnerable population." – by Jake Scott
Disclosure: The authors report no relevant financial disclosures.
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