TY - JOUR
T1 - Neurodevelopment After Neonatal Acute Kidney Injury in Very Preterm-Birth Children
AU - Chen, Chih Chia
AU - Chu, Chi Hsiang
AU - Lin, Yung Chieh
AU - Huang, Chao Ching
N1 - Funding Information:
This study was supported by grants from the Taiwan Ministry of Science and Technology (NSTC 111-2314-B006-001, MOST 111-2314-B006-012) and a grant from the National Cheng Kung University Hospital (NCKUH-11201003). The authors thank the Taiwan Premature Baby Foundation and all team members in charge of data collection. None of these individuals were compensated for their contributions. The corresponding author had full access to the data set used and analyzed during the current study. The datasets used during the current study are available from the corresponding author on reasonable request. C-CC and C-CH contributed to research idea and study design; Y-CL contributed to data acquisition; C-CC, C-HC, Y-CL, and C-CH contributed to data analysis/interpretation; C-CC and C-HC provided statistical analysis; C-CH provided supervision or mentorship. All authors contributed important intellectual content during manuscript drafting or revision.
Funding Information:
This study was supported by grants from the Taiwan Ministry of Science and Technology (NSTC 111-2314-B006-001, MOST 111-2314-B006-012) and a grant from the National Cheng Kung University Hospital (NCKUH-11201003). The authors thank the Taiwan Premature Baby Foundation and all team members in charge of data collection. None of these individuals were compensated for their contributions.
Publisher Copyright:
© 2023 International Society of Nephrology
PY - 2023/9
Y1 - 2023/9
N2 - Introduction: This study aimed to assess head circumference (HC) growth and neurodevelopmental outcomes in very preterm-birth children after neonatal acute kidney injury (AKI). Methods: This longitudinal follow-up cohort included 732 very preterm neonates of gestational age <31 weeks admitted to a tertiary center between 2008 and 2020. AKI was categorized as nonoliguric and oliguric AKI based on the urine output criteria during admission. We compared the differences in death, z scores of HC (zHC) at term-equivalent age (TEA) and at corrected ages of 6, 12, and 24 months, and the neurodevelopmental outcomes at corrected age of 24 months after neonatal nonoliguric and oliguric AKI. Results: Among the 154 neonates who developed AKI, 72 had oliguric AKI and 82 had nonoliguric AKI. At TEA, oliguric AKI, but not nonoliguric AKI, was independently associated with lower zHC than non-AKI (mean differences, −0.49; 95% confidence interval [CI], −0.92 to −0.06). Although the 3 groups were comparable in zHC at corrected ages of 6, 12, and 24 months, the oliguric AKI group, but not the nonoliguric AKI group, had a higher rate of microcephaly by corrected age of 24 months. In addition, the oliguric AKI group, but not the nonoliguric AKI group, was more likely to die (61% vs. 9%) and have neurodevelopmental impairment (41% vs. 14%) compare with the non-AKI group. After adjustment, oliguric (adjusted odds ratio [aOR], 8.97; 95% CI, 2.19–36.76), but not nonoliguric, AKI was associated with neurodevelopmental impairment. Conclusion: Neonatal oliguric AKI is associated with neurodevelopmental impairment in very preterm-birth children. Long-term head-size and neurodevelopmental follow-up after neonatal AKI is warranted.
AB - Introduction: This study aimed to assess head circumference (HC) growth and neurodevelopmental outcomes in very preterm-birth children after neonatal acute kidney injury (AKI). Methods: This longitudinal follow-up cohort included 732 very preterm neonates of gestational age <31 weeks admitted to a tertiary center between 2008 and 2020. AKI was categorized as nonoliguric and oliguric AKI based on the urine output criteria during admission. We compared the differences in death, z scores of HC (zHC) at term-equivalent age (TEA) and at corrected ages of 6, 12, and 24 months, and the neurodevelopmental outcomes at corrected age of 24 months after neonatal nonoliguric and oliguric AKI. Results: Among the 154 neonates who developed AKI, 72 had oliguric AKI and 82 had nonoliguric AKI. At TEA, oliguric AKI, but not nonoliguric AKI, was independently associated with lower zHC than non-AKI (mean differences, −0.49; 95% confidence interval [CI], −0.92 to −0.06). Although the 3 groups were comparable in zHC at corrected ages of 6, 12, and 24 months, the oliguric AKI group, but not the nonoliguric AKI group, had a higher rate of microcephaly by corrected age of 24 months. In addition, the oliguric AKI group, but not the nonoliguric AKI group, was more likely to die (61% vs. 9%) and have neurodevelopmental impairment (41% vs. 14%) compare with the non-AKI group. After adjustment, oliguric (adjusted odds ratio [aOR], 8.97; 95% CI, 2.19–36.76), but not nonoliguric, AKI was associated with neurodevelopmental impairment. Conclusion: Neonatal oliguric AKI is associated with neurodevelopmental impairment in very preterm-birth children. Long-term head-size and neurodevelopmental follow-up after neonatal AKI is warranted.
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U2 - 10.1016/j.ekir.2023.06.020
DO - 10.1016/j.ekir.2023.06.020
M3 - Article
AN - SCOPUS:85165026447
SN - 2468-0249
VL - 8
SP - 1784
EP - 1791
JO - Kidney International Reports
JF - Kidney International Reports
IS - 9
ER -