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29-03-2023 | Intrauterine Growth Restriction | Original Article

Association of intrauterine growth restriction and low birth weight with acute kidney injury in preterm neonates

Authors: Mariateresa Sinelli, Emanuela Zannin, Daniela Doni, Sara Ornaghi, Eleonora Acampora, Nadia Roncaglia, Patrizia Vergani, Maria Luisa Ventura

Published in: Pediatric Nephrology | Issue 9/2023

Abstract

Background

Preterm birth alters nephrogenesis and reduces the total nephron number. Intrauterine growth restriction (IUGR) seems to worsen nephron loss, but only a few studies have investigated its role in neonatal kidney impairment. We investigated whether IUGR, defined as reduced estimated fetal growth and/or placental flow alterations and low birth weight z-score, increases the risk of developing acute kidney injury (AKI) in very preterm infants.

Methods

We performed a retrospective study including infants born with a birth weight (BW) ≤ 1500 g and/or gestational age (GA) ≤ 32 weeks admitted to our center between January 2016 and December 2021. Neonatal AKI was defined according to the neonatal KDIGO classification based on the decline of urine output and/or creatinine elevation. We used multivariable linear regressions to verify the association between AKI and GA, BW z-score, IUGR definition, and hemodynamically significant patent ductus arteriosus (PDA).

Results

We included 282 infants in the analysis, with a median (IQR) GA = 29.4 (27.4, 31.3) weeks, BW = 1150 (870, 1360) g, and BW z-score = − 0.57 (− 1.64, 0.25). AKI was diagnosed in 36 (13%) patients, and 58 (21%) had PDA. AKI was significantly associated with BW z-score (beta (std. error) = − 0.08 (0.03), p = 0.008) and severe IUGR (beta (std. error) = 0.21 (0.08), p = 0.009), after adjusting for GA and PDA.

Conclusions

Our data suggest that low BW z-score and IUGR could represent adjunctive risk factors for kidney impairment in preterm babies.

Graphical abstract

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Title: Association of intrauterine growth restriction and low birth weight with acute kidney injury in preterm neonates
Authors: Mariateresa Sinelli
Emanuela Zannin
Daniela Doni
Sara Ornaghi
Eleonora Acampora
Nadia Roncaglia
Patrizia Vergani
Maria Luisa Ventura
Publication date: 29-03-2023
Publisher: Springer Berlin Heidelberg
Keywords: Intrauterine Growth Restriction
Patent Ductus Arteriosus
Patent Ductus Arteriosus
Acute Kidney Injury
Patent Ductus Arteriosus
Patent Ductus Arteriosus
Acute Kidney Injury
Published in: Pediatric Nephrology / Issue 9/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-023-05936-8

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Springer Medicine

Association of intrauterine growth restriction and low birth weight with acute kidney injury in preterm neonates

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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