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Prevalence of acute kidney injury (AKI) in extremely low gestational age neonates (ELGAN).
Pediatric Nephrology ( IF 2.6 ) Pub Date : 2020-06-02 , DOI: 10.1007/s00467-020-04563-x
David J Askenazi 1, 2 , Patrick J Heagerty 3 , Robert H Schmicker 3 , Russell Griffin 4 , Patrick Brophy 5 , Sandra E Juul 6 , Dennis E Mayock 6 , Stuart L Goldstein 7 , Sangeeta Hingorani 6 ,
Affiliation  

BACKGROUND To determine the prevalence and severity of acute kidney injury (AKI) at different time frames in relation to gestational age (GA) and birthweight (BW) in extremely low gestational age neonates (ELGAN). Our hypothesis is that ELGAN with lower GA and lower BW have higher AKI rates. METHODS A total of 923 ELGAN enrolled in the Preterm Erythropoietin Neuroprotection Trial were evaluated from birth until death or hospital discharge. AKI was defined according to kidney disease: improving global outcomes (KDIGO) definition from clinically-derived serum creatinine (SCr) measurements. Severe AKI was defined as stage 2 or higher. RESULTS For the entire cohort, 351/923 (38.0%, CI = 34.8-41.3%) had at least one episode of stage 1 or higher AKI and 168/923 (18.2%, CI = 15.7-20.7%) had at least one episode of severe (stage 2 or higher) AKI. The prevalence of AKI stage 1 or higher for the entire cohort during the early (days 3-7), middle (days 8-14), and late follow-up period (after day 14) was 112/923 (12.1%, CI = 10.0-14.3%), 142/891 (15.9%, CI = 13.5-18.4%), and 249/875 (28.5%, CI = 25.4-31.5%), respectively. The rates of severe AKI during the hospital course were 27.8%, 21.9%, 13.6%, and 9.4% for the 24-, 25-, 26-, and 27-week GA groups, respectively. AKI rates were significantly higher with decreasing GA and decreasing BW for stated time trends (all p < 0.01 using tests for trend). CONCLUSIONS AKI is relatively common in ELGAN during their initial hospital course and is associated with lower GA and BW.

中文翻译:

极低胎龄新生儿 (ELGAN) 中急性肾损伤 (AKI) 的患病率。

背景 为了确定与胎龄 (GA) 和出生体重 (BW) 相关的极低胎龄新生儿 (ELGAN) 在不同时间范围内急性肾损伤 (AKI) 的患病率和严重程度。我们的假设是具有较低 GA 和较低 BW 的 ELGAN 具有较高的 AKI 率。方法 对参加早产促红细胞生成素神经保护试验的 923 名 ELGAN 进行了从出生到死亡或出院的评估。AKI 是根据肾脏疾病定义的:根据临床衍生的血清肌酐 (SCr) 测量改善总体结果 (KDIGO) 定义。严重 AKI 被定义为 2 级或更高。结果 对于整个队列,351/923 (38.0%, CI = 34.8-41.3%) 至少有一次 1 期或更高 AKI 发作,168/923 (18.2%, CI = 15.7-20.7%) 至少有一次严重(2 期或更高)AKI 发作。在早期(第 3-7 天)、中期(第 8-14 天)和晚期(第 14 天之后)整个队列的 AKI 1 期或更高的患病率是 112/923(12.1%,CI = 10.0-14.3%)、142/891(15.9%,CI = 13.5-18.4%)和 249/875(28.5%,CI = 25.4-31.5%)。24 周、25 周、26 周和 27 周 GA 组住院期间严重 AKI 的发生率分别为 27.8%、21.9%、13.6% 和 9.4%。对于规定的时间趋势,随着 GA 的降低和 BW 的降低,AKI 率显着升高(使用趋势检验,所有 p < 0.01)。结论 AKI 在 ELGAN 的初始住院过程中相对常见,并且与较低的 GA 和 BW 相关。0-14.3%)、142/891(15.9%,CI = 13.5-18.4%)和 249/875(28.5%,CI = 25.4-31.5%)。24 周、25 周、26 周和 27 周 GA 组住院期间严重 AKI 的发生率分别为 27.8%、21.9%、13.6% 和 9.4%。对于规定的时间趋势,随着 GA 的降低和 BW 的降低,AKI 率显着升高(使用趋势检验,所有 p < 0.01)。结论 AKI 在 ELGAN 的初始住院过程中相对常见,并且与较低的 GA 和 BW 相关。0-14.3%)、142/891(15.9%,CI = 13.5-18.4%)和 249/875(28.5%,CI = 25.4-31.5%)。24 周、25 周、26 周和 27 周 GA 组住院期间严重 AKI 的发生率分别为 27.8%、21.9%、13.6% 和 9.4%。对于规定的时间趋势,随着 GA 的降低和 BW 的降低,AKI 率显着升高(使用趋势检验,所有 p < 0.01)。结论 AKI 在 ELGAN 的初始住院过程中相对常见,并且与较低的 GA 和 BW 相关。01 使用趋势测试)。结论 AKI 在 ELGAN 的初始住院过程中相对常见,并且与较低的 GA 和 BW 相关。01 使用趋势测试)。结论 AKI 在 ELGAN 的初始住院过程中相对常见,并且与较低的 GA 和 BW 相关。
更新日期:2020-06-02
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