BACKGROUND Acute kidney injury (AKI) is common in neonatal encephalopathy (NE) and is associated with worse outcomes. Our objectives were to determine the incidence, risk factors, and outcomes of AKI in infants with NE. METHODS We performed a retrospective analysis of infants ≥ 34 weeks' gestational age with a diagnosis of NE from the Analysis of Worldwide Acute Kidney injury Epidemiology in Neonates (AWAKEN) database. AKI was defined using the modified Kidney Disease Improving Global Outcomes criteria. Perinatal and postnatal factors were evaluated. Multivariate logistic and linear regressions were performed. RESULTS One hundred and thirteen patients with NE were included. 41.6% (47) developed AKI. Being born outside the admitting institution (OR 4.3; 95% CI 1.2-14.8; p = 0.02), intrauterine growth restriction (OR 10.3, 95% CI 1.1-100.5; p = 0.04), and meconium at delivery (OR 2.8, 95% CI 1.04-7.7; p = 0.04) conferred increased odds of AKI. After controlling for confounders, infants with AKI stayed in the hospital an average of 8.5 days longer than infants without AKI (95% CI 0.79-16.2 days; p = 0.03). CONCLUSIONS In this multi-national analysis, several important perinatal factors were associated with AKI and infants with both NE and AKI had longer length of stay than NE alone. Future research aimed at early AKI detection, renoprotective management strategies, and understanding the long-term renal consequences is warranted in this high-risk group of patients.

中文翻译：

---

新生儿脑病的急性肾损伤：AWAKEN 数据库的评估。

背景 急性肾损伤 (AKI) 在新生儿脑病 (NE) 中很常见，并且与较差的结局相关。我们的目标是确定 NE 婴儿 AKI 的发生率、危险因素和结果。方法 我们对全球新生儿急性肾损伤流行病学分析 (AWAKEN) 数据库中诊断为 NE 且胎龄≥ 34 周的婴儿进行了回顾性分析。AKI 是使用改良的肾脏疾病改善全球结果标准定义的。评估了围产期和产后因素。进行多变量逻辑回归和线性回归。结果 113 名 NE 患者被纳入。41.6% (47) 发生 AKI。在收治机构外出生（OR 4.3；95% CI 1.2-14.8；p = 0.02），宫内生长受限（OR 10.3，95% CI 1.1-100.5；p = 0.04）和分娩时胎粪（OR 2.8，95% CI 1.04-7.7；p = 0.04）增加了 AKI 的几率。控制混杂因素后，患有 AKI 的婴儿比没有 AKI 的婴儿平均住院时间长 8.5 天（95% CI 0.79-16.2 天；p = 0.03）。结论 在这项多国分析中，几个重要的围产期因素与 AKI 相关，同时患有 NE 和 AKI 的婴儿比单独患有 NE 的婴儿住院时间更长。未来的研究旨在早期发现 AKI、保护肾脏的管理策略和了解长期肾脏后果对这一高危患者群体是必要的。比没有 AKI 的婴儿长 5 天（95% CI 0.79-16.2 天；p = 0.03）。结论 在这项多国分析中，几个重要的围产期因素与 AKI 相关，同时患有 NE 和 AKI 的婴儿比单独患有 NE 的婴儿住院时间更长。未来的研究旨在早期发现 AKI、保护肾脏的管理策略和了解长期肾脏后果对这一高危患者群体是必要的。比没有 AKI 的婴儿长 5 天（95% CI 0.79-16.2 天；p = 0.03）。结论 在这项多国分析中，几个重要的围产期因素与 AKI 相关，同时患有 NE 和 AKI 的婴儿比单独患有 NE 的婴儿住院时间更长。未来的研究旨在早期发现 AKI、保护肾脏的管理策略和了解长期肾脏后果对这一高危患者群体是必要的。