Neonatal recurrent AKI may be linked with longer hospitalization
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Key takeaways:
- Of 605 neonates with AKI, 22% developed recurrent AKI.
- Risk factors were younger gestational age, lower birth weight and higher initial AKI stage.
Neonatal recurrent AKI may be associated with longer hospital stays compared with single AKI episodes, according to researchers.
AKI may “predispose neonates to subsequent kidney injury, and survivors of neonatal AKI are potentially at risk for long-term complications, including chronic kidney disease,” Austin D. Rutledge, DO, of the department of pediatrics at the Medical University of South Carolina, and researchers wrote. “It is important to better understand the incidence and outcomes associated with the occurrence of more than [one] episode of neonatal AKI after resolution of a previous AKI episode during the same hospitalization, or recurrent AKI.”
In a secondary analysis of the multicenter Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates retrospective study, investigators evaluated 2,162 neonates of which 57% were boys. The goal was to assess AKI incidence, risk factors and outcomes.
Neonates younger than 14 days admitted to one of 24 participating Level 2 to Level 4 neonatal ICUs between Jan. 1 and March 31, 2014, and who received IV fluids for at least 48 hours, were included in the analysis. Gestational age distribution was less than 29 weeks for 12.8% of neonates, 29 weeks to less than 36 weeks for 44.3% of neonates and 36 weeks or older for 42.9% of the study cohort. Data were analyzed from 2022 to 2023.
Of 605 neonates with AKI, 22% developed recurrent AKI, findings showed. Risk factors for recurrence were younger gestational age, lower birth weight and higher initial AKI stage. Infants with recurrent AKI had a median hospital length of stay of 60 days, longer than those with no AKI or a single episode of AKI, according to the study.
Rutledge and colleagues also found recurrent AKI was independently linked with a lower likelihood of discharge vs. single episodes. There was no significant difference in mortality rates groups, according to the study results.
The research provides “important information that will inform the development of evidence-based post-AKI care guidelines to prevent and diagnose [recurrent] AKI sooner to improve outcomes,” they wrote. “The present study suggests that [recurrent] AKI should be independently studied as a contributor to long-term kidney health in neonates.”
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