Acute Kidney Injury Reduces Survival in Very Low Birth Weight Infants

Koralkar, Rajesh; Ambalavanan, Namasivayam; Levitan, Emily B.; McGwin, Gerald; Goldstein, Stuart L.; Askenazi, David

doi:10.1203/pdr.0b013e31820b95ca

Cited by 287 publications

(223 citation statements)

References 23 publications

Supporting

Mentioning

192

Contrasting

Unclassified

Order By: Relevance

“…In critically ill neonates, AKI usually occurs in the first week of life (80.5%) (12), which was also confirmed in our study (80%).…”

Section: Discussionsupporting

confidence: 89%

“…Diagnostic criteria of AKI are still based on the increase in the SCr and/or urine output (12,20). Unfortunately, it is well known that the SCr is late biomarker for AKI.…”

Section: Discussionmentioning

confidence: 99%

“…become widely introduced in routine practice, the present definition of AKI will be indisputably expanded and upgraded, that will provide a possibility for early diagnosis of AKI well before SCr levels rise (6). In the meantime, until early biomarkers of AKI become routinely used, dynamics of SCr must be closely monitored in order to timely diagnose AKI and assess the severity of the disease (12).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Urinary kidney injury molecule-1 rapid test predicts acute kidney injury in extremely low-birth-weight neonates

et al. 2015

View full text Add to dashboard Cite

Background:The new urinary and serum biomarkers are discovered and are being investigated. With them we can diagnose acute kidney injury (AKI) faster and more precisely and they also have a significant role in the outcome prediction. Methods: The study included 22 extremely low-birthweight neonates who were hospitalized in the neonatal intensive care units. They were divided into two groups based on serum creatinine (SCr) level-with and without AKI. Detection and quantification of urinary kidney injury molecule-1 (uKIM-1) was done on the third day of life, using commercially available KIM-1 rapid test. Subsequently, measurements were repeated only in subjects who were diagnosed with AKI, at different values of SCr. results: Logistic regression analysis showed that AKI is an independent risk factor for mortality. In a group of neonates with AKI, 50% of neonates administered the KIM-1 rapid test showed positive findings. KIM-1 rapid test was positive in patients with a wide range of SCr levels (range of 78.73-385 µmol/l), but all subjects had oliguria and died in the next 24 h. conclusion: KIM-1 is a significant predictor of death. On the other hand, our study failed to prove that KIM-1 rapid test has any significance for early prediction of AKI.

show abstract

“…In critically ill neonates, AKI usually occurs in the first week of life (80.5%) (12), which was also confirmed in our study (80%).…”

Section: Discussionsupporting

confidence: 89%

“…Diagnostic criteria of AKI are still based on the increase in the SCr and/or urine output (12,20). Unfortunately, it is well known that the SCr is late biomarker for AKI.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Urinary kidney injury molecule-1 rapid test predicts acute kidney injury in extremely low-birth-weight neonates

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The risk for AKI in premature infants is highest in those with lower gestational age. The incidence of AKI in this group is estimated to be between 12 and 40% (18)(19)(20). Other neonatal cohorts at high risk of developing AKI include those with congenital heart disease who receive cardiopulmonary bypass, near-term/term sick infants requiring intensive care, neonates with hypoxic-ischemic encephalopathy, necrotizing enterocolitis, sepsis, and neonates who receive extra-corporeal membrane oxygenation.…”

Section: Statement Of the Problemmentioning

confidence: 99%

Strategies to improve the understanding of long-term renal consequences after neonatal acute kidney injury

et al. 2015

View full text Add to dashboard Cite

“…The findings of single-center prospective studies in very low birth weight (VLBW) infants [1], infants who undergo cardiopulmonary bypass [2,3], infants requiring extracorporal pulmonary oxygenation [4,5], and infants with perinatal birth asphyxia [6] suggest that neonatal AKI is common and associated with poor outcomes [7,8]. To define AKI, these studies have used serum creatinine (SCr) alone, or SCr and urine output criteria.…”

mentioning

confidence: 99%

Are we ready for the clinical use of novel acute kidney injury biomarkers?

Askenazi

2012

Pediatr Nephrol

Self Cite

View full text Add to dashboard Cite

Acute kidney injury (AKI) is a common event in several neonatal populations, and those neonates with AKI have poor outcomes. Serum creatinine (SCr)-based definitions of AKI are not ideal and are additionally limited in neonates whose SCr reflects the maternal creatinine level at birth and normally drops over the first weeks of life dependent on gestational age. Recent studies show that urine and serum biomarkers may provide a better basis than SCr on which to diagnose AKI. In this month's issue of Pediatric Nephrology, Sarafidis et al. show that urine neutrophil gelatinase-associated lipocalin (uNGAL), serum NGAL (sNGAL), and urine cystatin c (uCysC) are highest in those neonates with asphyxia who have elevated SCr. Furthermore, those with asphyxia without a concomitant rise in SCr levels have elevated levels of biomarkers compared to controls, suggesting a dose response. Once the SCr level returns to normal, the levels of novel AKI biomarkers continue to be elevated. While these findings strengthen the argument for the clinical use of these AKI biomarkers, further work is needed before they can be implemented in clinical practice. Large-scale observational multi-center studies are needed to test these biomarkers against hard clinical endpoints. In addition, randomized intervention trials which use biomarkers to define AKI need to be performed.Keywords Acute kidney injury . Ngal . Cystatin c . Asphyxia . Newborn . NeonatesOver the last few years our understanding of the incidence and outcomes in neonates who have acute kidney injury (AKI) has improved. The findings of single-center prospective studies in very low birth weight (VLBW) infants [1], infants who undergo cardiopulmonary bypass [2,3], infants requiring extracorporal pulmonary oxygenation [4,5], and infants with perinatal birth asphyxia [6] suggest that neonatal AKI is common and associated with poor outcomes [7,8]. To define AKI, these studies have used serum creatinine (SCr) alone, or SCr and urine output criteria. Although SCr is currently the most available method to define AKI, SCrbased AKI definitions are not ideal for numerous reasons. Firstly, because SCr is a measure of function (not injury), it is a late biomarker for an acute injury. Secondly, due to renal function reserve, more than 50 % of nephrons must be compromised before changes in SCr level are evident. Therefore, SCr is at best a late marker of significant renal dysfunction. In neonates, SCr-based AKI definitions are additionally complicated because at birth SCr reflects maternal creatinine, which improves over the first few weeks of life, dependent on gestational age [9]. For these and other reasons, newer definitions of a neonatal AKI using noninvasive serum and urine biomarkers are greatly needed.Studies in VLBW infants [10,11], infants who undergo cardiopulmonary bypass surgery [3,[12][13][14][15][16][17], and other sick newborns admitted to a neonatal intensive care unit [18] suggest that such biomarkers can detect those infants who will later have a rise in SCr and that...

show abstract

Acute Kidney Injury Reduces Survival in Very Low Birth Weight Infants

Cited by 287 publications

References 23 publications

Urinary kidney injury molecule-1 rapid test predicts acute kidney injury in extremely low-birth-weight neonates

Urinary kidney injury molecule-1 rapid test predicts acute kidney injury in extremely low-birth-weight neonates

Strategies to improve the understanding of long-term renal consequences after neonatal acute kidney injury

Are we ready for the clinical use of novel acute kidney injury biomarkers?

Contact Info

Product

Resources

About