Renal Saturations and Acute Kidney Injury in the Preterm Infant with Patent Ductus Arteriosus

Abstract

Objective: Decreased near-infrared spectroscopy (NIRS) measures of renal saturation (Rsat) have identified hemodynamically significant PDA (hsPDA) and may delineate infants at risk for acute kidney injury (AKI). Design: Review of infants 29 weeks gestation undergoing NIRS and echocardiography due to concern for PDA. hsPDA was defined by two of the following: moderate-large size, left to right shunt, aortic flow reversal, left atrial enlargement. AKI was defined by neonatal KDIGO. Rsat and cerebral saturation (Csat) were evaluated for 24 hours before echocardiography. Result: Among 77 infants, hsPDA was found on echocardiography in 59 (77%). There were no differences in hsPDA in infants with and without AKI. Rsat was not associated with AKI (p=0.3) or hsPDA (p=0.5). Infants on dopamine had less Rsat variability (p=0.001). Conclusion: Rsat prior to echocardiography did not discriminate AKI in the preterm hsPDA population, however data may not capture optimal timing of Rsat measurement before AKI.