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Pediatric Nephrology

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01-02-2022 | Acute Kidney Injury | Systematic Review/Meta-analysis

Acute kidney injury in premature and low birth weight neonates: a systematic review and meta-analysis

Authors: Yang Wu, Haoran Wang, Jiao Pei, Xiaoping Jiang, Jun Tang

Published in: Pediatric Nephrology | Issue 2/2022

Abstract

Background

Acute kidney injury (AKI) is common and it is associated with poor clinical outcomes in premature and low birth weight neonates. This systematic review and meta-analysis was performed to summarize the literature and evaluate the prevalence, risk factors, and mortality of premature and low birth weight neonates with AKI.

Methods

A systematic search in PubMed, Embase, and the Cochrane Library was performed. Studies on the prevalence, risk factors, diagnosis, and outcomes of acute kidney injury in preterm neonates and neonates with low birth weight were included and analyzed.

Results

Fifty articles of 10,744 patients were included in this study. The overall rate of AKI from the pooled results of all patients was 25% (95% CI 20–30%) with heterogeneity among studies (I² = 97%; P < 0.01). Patients with AKI had significantly higher rate of mortality than patients without AKI (odds ratio (OR) = 7.13; 95% CI 5.91–8.60; P < 0.01).

Conclusions

AKI was prevalent and was associated with high mortality rate among preterm and low birth weight neonates.

Graphical abstract

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Selewski DT, Charlton JR, Jetton JG, Guillet R, Mhanna MJ, Askenazi DJ, Kent AL (2015) Neonatal acute kidney injury. Pediatrics 136:e463-473PubMed

Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE, Chishti AS, Woroniecki R, Mammen C, Swanson JR, Sridhar S, Wong CS, Kupferman JC, Griffin RL, Askenazi DJ, Neonatal Kidney Collaborative (NKC) (2017) Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study. Lancet Child Adolesc Health 1:184–194CrossRefPubMedPubMedCentral

Shalaby MA, Sawan ZA, Nawawi E, Alsaedi S, Al-Wassia H, Kari JA (2018) Incidence, risk factors, and outcome of neonatal acute kidney injury: a prospective cohort study. Pediatr Nephrol 33:1617–1624PubMed

Selewski DT, Cornell TT, Heung M, Troost JP, Ehrmann BJ, Lombel RM, Blatt NB, Luckritz K, Hieber S, Gajarski R, Kershaw DB, Shanley TP, Gipson DS (2014) Validation of the KDIGO acute kidney injury criteria in a pediatric critical care population. Intensive Care Med 40:1481–1488PubMed

Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL (2007) Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 71:1028–1035PubMed

Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A, Acute Kidney Injury Network (2007) Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 11:R31PubMedPubMedCentral

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097PubMedPubMedCentral

Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P (2009) The Newcastle-Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

Viechtbauer W (2010) Conducting meta-analysis in R with the metafor package. J Stat Softw 36:1–48

10.

Gordon M, Lumley T (2015) Package ‘forest plot.’ Available at: https://cran.r-project.org/web/packages/forestplot/

11.

Dorum BA, Ozkan H, Cetinkaya M, Koksal N (2021) Regional oxygen saturation and acute kidney injury in premature neonates. Pediatr Int 63:290–294PubMed

12.

Askenazi DJ, Heagerty PJ, Schmicker RH, Griffin R, Brophy P, Juul SE, Mayock DE, Goldstein SL, Hingorani S, PENUT Trial Consortium (2020) Prevalence of acute kidney injury (AKI) in extremely low gestational age neonates (ELGAN). Pediatr Nephrol 35:1737–1748PubMedPubMedCentral

13.

Kaya H, Gokce İK, Turgut H, Özdemir R, Tabel Y (2020) Acute kidney injury and peritoneal dialysis in extremely low birth weight neonates. Minerva Pediatr. https://doi.org/10.23736/S0026-4946.20.05617-0

14.

Mazaheri M, Rambod M (2019) Risk factors analysis for acute kidney injury in the newborn neonates: predictive strategies. Iran J Kidney Dis 13:310–315PubMed

15.

Bonsante F, Ramful D, Binquet C, Samperiz S, Daniel S, Gouyon JB, Iacobelli S (2019) Low renal oxygen saturation at near-infrared spectroscopy on the first day of life is associated with developing acute kidney injury in very preterm neonates. Neonatology 115:198–204PubMed

16.

Aviles-Otero N, Kumar R, Khalsa DD, Green G, Carmody JB (2019) Caffeine exposure and acute kidney injury in premature neonates with necrotizing enterocolitis and spontaneous intestinal perforation. Pediatr Nephrol 34:729–736PubMed

17.

Harer MW, McAdams RM, Conaway M, Vergales BD, Hyatt DM, Charlton JR (2020) Delayed umbilical cord clamping is not associated with acute kidney injury in very low birth weight neonates. Am J Perinatol 37:210–215PubMed

18.

Ladeiras R, Flor-De-Lima F, Soares H, Oliveira B, Guimarães H (2019) Acute kidney injury in preterm neonates with ≤30 weeks of gestational age and its risk factors. Minerva Pediatr 71:404–414PubMed

19.

Lei C, Liu H, Wang H, Liu C (2019) Effectiveness and renal functions safety of treatments used for neonates with patent ductus arteriosus: a prospective cohort study. Med Sci Monit 25:3668–3675PubMedPubMedCentral

20.

Majed B, Bateman DA, Uy N, Lin F (2019) Patent ductus arteriosus is associated with acute kidney injury in the preterm infant. Pediatr Nephrol 34:1129–1139PubMed

21.

Waldherr S, Fichtner A, Beedgen B, Bruckner T, Schaefer F, Tönshoff B, Pöschl J, Westhoff TH, Westhoff JH (2019) Urinary acute kidney injury biomarkers in very low-birth-weight neonates on indomethacin for patent ductus arteriosus. Pediatr Res 85:678–686PubMed

22.

Velazquez DM, Reidy KJ, Sharma M, Kim M, Vega M, Havranek T (2019) The effect of hemodynamically significant patent ductus arteriosus on acute kidney injury and systemic hypertension in extremely low gestational age neonates. J Matern Fetal Neonatal Med 32:3209–3214PubMed

23.

El-Gammacy TM, Shinkar DM, Mohamed NR, Al-Halag AR (2018) Serum cystatin C as an early predictor of acute kidney injury in preterm neonates with respiratory distress syndrome. Scand J Clin Lab Invest 78:352–357PubMed

24.

Harer MW, Askenazi DJ, Boohaker LJ, Carmody JB, Griffin RL, Guillet R, Selewski DT, Swanson JR, Charlton JR, Neonatal Kidney Collaborative (NKC) (2018) Association between early caffeine citrate administration and risk of acute kidney injury in preterm neonates: results from the AWAKEN study. JAMA Pediatr 172:e180322PubMedPubMedCentral

25.

Bakhoum CY, Basalely A, Koppel RI, Sethna CB (2019) Acute kidney injury in preterm neonates with necrotizing enterocolitis. J Matern Fetal Neonatal Med 32:3185–3190PubMed

26.

Elmas AT, Tabel Y, Özdemir R (2018) Risk factors and mortality rate in premature neonates with acute kidney injury. J Clin Lab Anal 32:e22441PubMedPubMedCentral

27.

Aygün A, Poryo M, Wagenpfeil G, Wissing A, Ebrahimi-Fakhari D, Zemlin M, Gortner L, Meyer S (2019) Birth weight, Apgar scores and gentamicin were associated with acute kidney injuries in VLBW neonates requiring treatment for patent ductus arteriosus. Acta Paediatr 108:645–653PubMed

28.

Stojanović VD, Barišić NA, Radovanović TD, Kovač NB, Djuran JD, Antić APE, Doronjski AD (2018) Serum glutathione S-transferase Pi as predictor of the outcome and acute kidney injury in premature neonates. Pediatr Nephrol 33:1251–1256PubMed

29.

Sellmer A, Bech BH, Bjerre JV, Schmidt MR, Hjortdal VE, Esberg G, Rittig S, Henriksen TB (2017) Urinary neutrophil gelatinase-associated lipocalin in the evaluation of patent ductus arteriosus and AKI in very preterm neonates: a cohort study. BMC Pediatr 17:7PubMedPubMedCentral

30.

Al Malla M, Varghese NV, AlAbdullatif M, Narchi H, Khassawneh M (2017) Prevalence and outcome of acute kidney injury, as defined by the new Kidney Disease Improving Global Outcomes guideline, in very low birth weight neonates. World J Nephrol 6:229–235PubMedPubMedCentral

31.

Maqsood S, Fung N, Chowdhary V, Raina R, Mhanna MJ (2017) Outcome of extremely low birth weight neonates with a history of neonatal acute kidney injury. Pediatr Nephrol 32:1035–1043PubMed

32.

Lee CC, Chan OW, Lai MY, Hsu KH, Wu TW, Lim WH, Wang YC, Lien R (2017) Incidence and outcomes of acute kidney injury in extremely-low-birth-weight neonates. PLoS One 12:e0187764PubMedPubMedCentral

33.

Chowdhary V, Vajpeyajula R, Jain M, Maqsood S, Raina R, Kumar D, Mhanna MJ (2018) Comparison of different definitions of acute kidney injury in extremely low birth weight neonates. Clin Exp Nephrol 22:117–125PubMed

34.

Stojanović V, Barišić N, Radovanović T, Bjelica M, Milanović B, Doronjski A (2017) Acute kidney injury in premature neonates-definition, etiology, and outcome. Pediatr Nephrol 32:1963–1970PubMed

35.

Srinivasan N, Schwartz A, John E, Price R, Amin S (2018) Acute kidney injury impairs postnatal renal adaptation and increases morbidity and mortality in very low-birth-weight neonates. Am J Perinatol 35:39–47PubMed

36.

Stoops C, Sims B, Griffin R, Askenazi DJ (2016) Neonatal acute kidney injury and the risk of intraventricular hemorrhage in the very low birth weight infant. Neonatology 110:307–312PubMed

37.

Parravicini E, Locatelli C, Lorenz JM, Nemerofsky SL, Bateman DA (2016) Is urinary neutrophil gelatinase-associated lipocalin able to predict acute kidney injury episodes in very low birth weight neonates in clinical settings? Pediatr Res 80:663–667PubMed

38.

Daga A, Dapaah-Siakwan F, Rajbhandari S, Arevalo C, Salvador A (2017) Diagnosis and risk factors of acute kidney injury in very low birth weight neonates. Pediatr Neonatol 58:258–263PubMed

39.

Carmody JB, Harer MW, Denotti AR, Swanson JR, Charlton JR (2016) Caffeine exposure and risk of acute kidney injury in a retrospective cohort of very low birth weight neonates. J Pediatr 172:63-68.e1PubMed

40.

Elmas AT, Karadag A, Tabel Y, Ozdemir R, Otlu G (2017) Analysis of urine biomarkers for early determination of acute kidney injury in non-septic and non-asphyxiated critically ill preterm neonates. J Matern Fetal Neonatal Med 30:302–308PubMed

41.

Askenazi DJ, Koralkar R, Patil N, Halloran B, Ambalavanan N, Griffin R (2016) Acute kidney injury urine biomarkers in very low-birth-weight neonates. Clin J Am Soc Nephrol 11:1527–1535PubMedPubMedCentral

42.

Nagaraj N, Berwal PK, Srinivas A, Berwal A (2016) A study of acute kidney injury in hospitalized preterm neonates in NICU. J Neonatal Perinatal Med 9:417–421PubMed

43.

Kuribayashi R, Suzumura H, Sairenchi T, Watabe Y, Tsuboi Y, Imataka G, Kurosawa H, Arisaka O (2016) Urinary neutrophil gelatinase-associated lipocalin is an early predictor of acute kidney injury in premature neonates. Exp Ther Med 12:3706–3710PubMedPubMedCentral

44.

Ginovart G, Gich I, Verd S (2016) Formula feeding is independently associated with acute kidney injury in very low birth weight neonates. J Hum Lact 32:NP111–NP115PubMed

45.

Weintraub AS, Connors J, Carey A, Blanco V, Green RS (2016) The spectrum of onset of acute kidney injury in premature neonates less than 30 weeks gestation. J Perinatol 36:474–480PubMed

46.

Mian AN, Guillet R, Ruck L, Wang H, Schwartz GJ (2016) Acute kidney injury in premature, very low-birth-weight neonates. J Pediatr Intensive Care 5:69–78PubMed

47.

Suchojad A, Tarko A, Smertka M, Majcherczyk M, Brzozowska A, Wroblewska J, Maruniak-Chudek I (2015) Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm neonates. Ren Fail 37:439–445PubMed

48.

Stojanović VD, Barišić NA, Vučković NM, Doronjski AD, PecoAntić AE (2015) Urinary kidney injury molecule-1 rapid test predicts acute kidney injury in extremely low-birth-weight neonates. Pediatr Res 78:430–435PubMed

49.

Pejović B, Erić-Marinković J, Pejović M, Kotur-Stevuljević J, Peco-Antić A (2015) Detection of acute kidney injury in premature asphyxiated neonates by serum neutrophil gelatinase-associated lipocalin (sNGAL)–sensitivity and specificity of a potential new biomarker. Biochem Med (Zagreb) 25:450–459

50.

Arcinue R, Kantak A, Elkhwad M (2015) Acute kidney injury in ELBW neonates (< 750 grams) and its associated risk factors. J Neonatal Perinatal Med 8:349–357PubMed

51.

Sarafidis K, Tsepkentzi E, Diamanti E, Agakidou E, Taparkou A, Soubasi V, Papachristou F, Drossou V (2014) Urine neutrophil gelatinase-associated lipocalin to predict acute kidney injury in preterm neonates. A pilot study. Pediatr Nephrol 29:305–310PubMed

52.

Carmody JB, Swanson JR, Rhone ET, Charlton JR (2014) Recognition and reporting of AKI in very low birth weight neonates. Clin J Am Soc Nephrol 9:2036–2043PubMedPubMedCentral

53.

Stojanović V, Barišić N, Milanović B, Doronjski A (2014) Acute kidney injury in preterm neonates admitted to a neonatal intensive care unit. Pediatr Nephrol 29:2213–2220PubMed

54.

Elmas AT, Tabel Y, Elmas ON (2014) Serum cystatin C predicts acute kidney injury in preterm neonates with respiratory distress syndrome. Pediatr Nephrol 28:477–484

55.

Tabel Y, Elmas A, Ipek S, Karadag A, Elmas O, Ozyalin F (2014) Urinary neutrophil gelatinase-associated lipocalin as an early biomarker for prediction of acute kidney injury in preterm neonates. Am J Perinatol 31:167–174PubMed

56.

Viswanathan S, Manyam B, Azhibekov T, Mhanna MJ (2012) Risk factors associated with acute kidney injury in extremely low birth weight (ELBW) neonates. Pediatr Nephrol 27:303–311PubMed

57.

Koralkar R, Ambalavanan N, Levitan EB, McGwin G, Goldstein S, Askenazi D (2011) Acute kidney injury reduces survival in very low birth weight neonates. Pediatr Res 69:354–358PubMed

58.

Lee BS, Byun SY, Chung ML, Chang JY, Kim HY, Kim EA, Kim KS, Pi SY (2010) Effect of furosemide on ductal closure and renal function in indomethacin-treated preterm neonates during the early neonatal period. Neonatology 98:191–199PubMed

59.

Csaicsich D, Russo-Schlaff N, Messerschmidt A, Weninger M, Pollak A, Aufricht C (2008) Renal failure, comorbidity and mortality in preterm neonates. Wien Klin Wochenschr 120:153–157PubMed

60.

Cataldi L, Leone R, Moretti U, De Mitri B, Fanos V, Ruggeri L, Sabatino G, Torcasio F, Zanardo V, Attardo G, Riccobene F, Martano C, Benini D, Cuzzolin L (2005) Potential risk factors for the development of acute renal failure in preterm newborn neonates: a case-control study. Arch Dis Child Fetal Neonatal Ed 90:F514-519PubMedPubMedCentral

61.

Miall LS, Henderson MJ, Turner AJ, Brownlee KG, Brocklebank JT, Newell SJ, Allgar VL (1999) Plasma creatinine rises dramatically in the first 48 hours of life in preterm neonates. Pediatrics 104:e76PubMed

62.

Auron A, Mhanna MJ (2006) Serum creatinine in very low birth weight neonates during their first days of life. J Perinatol 26:755–760PubMed

Title: Acute kidney injury in premature and low birth weight neonates: a systematic review and meta-analysis
Authors: Yang Wu
Haoran Wang
Jiao Pei
Xiaoping Jiang
Jun Tang
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Keywords: Acute Kidney Injury
Acute Kidney Injury
Published in: Pediatric Nephrology / Issue 2/2022
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-021-05251-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Acute kidney injury in premature and low birth weight neonates: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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