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Pediatric Nephrology

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01-07-2016 | Original Article

A new approach to define acute kidney injury in term newborns with hypoxic ischemic encephalopathy

Authors: Charu Gupta, An N. Massaro, Patricio E. Ray

Published in: Pediatric Nephrology | Issue 7/2016

Abstract

Background

Current definitions of acute kidney injury (AKI) are not sufficiently sensitive to identify all newborns with AKI during the first week of life.

Methods

To determine whether the rate of decline of serum creatinine (SCr) during the first week of life can be used to identify newborns with AKI, we reviewed the medical records of 106 term neonates at risk of AKI who were treated with hypothermia for hypoxic ischemic encephalopathy (HIE).

Results

Of the newborns enrolled in the study, 69 % showed a normal rate of decline of SCr to ≥50 % and/or reached SCr levels of ≤0.6 mg/dl before the 7th day of life, and therefore had an excellent clinical outcome (control group). Thirteen newborns with HIE (12 %) developed AKI according to an established neonatal definition (AKI–KIDGO group), and an additional 20 newborns (19 %) showed a rate of decline of SCr of <33, <40, and <46 % from birth to days 3, 5, or 7 of life, respectively (delayed rise in estimated SCr clearance group). Compared to the control group, newborns in the other two groups required more days of mechanical ventilation and vasopressor drugs and had higher gentamicin levels, more fluid overload, lower urinary epidermal growth factor levels, and a prolonged length of stay.

Conclusions

The rate of decline of SCr provides a sensitive approach to identify term newborns with AKI during the first week of life.

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Title: A new approach to define acute kidney injury in term newborns with hypoxic ischemic encephalopathy
Authors: Charu Gupta
An N. Massaro
Patricio E. Ray
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 7/2016
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-016-3317-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A new approach to define acute kidney injury in term newborns with hypoxic ischemic encephalopathy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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