Acute Kidney Injury in Very Preterm Infants: A Cohort Study in a Level III NICU

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BACKGROUND/AIMS: Acute kidney injury (AKI) is not rare among preterm infants in neonatal intensive care units (NICU).It raises mortality and morbidity in NICU and also chronic kidney disease in the long term.The aim of the study was to define the incidence of clinical characteristics and the course of AKI in very preterm infants. MATERIALS AND METHODS:A retrospective cohort study was conducted in a level III NICU in a University Hospital, all very preterm infants born in the same hospital during the study period were included in the study.Patient data were taken from the medical records.AKI diagnosis was made using neonatal-modified Kidney Disease Improving Global Outcomes (KDIGO) criteria.RESULTS: AKI was diagnosed in 20 very preterm infants (42%).The median time of AKI diagnosis was 4.5 days of life (between 2-12 days).While there were 8 infants with AKI when the diagnosis was made based on the serum Cr level being over 1.5, the diagnosis of AKI increased to 20 with the use of KDIGO criteria.Need for resuscitation in the birth room, patent ductus arteriosus, the number of apnea, desaturation episodes, sepsis, hypotension, inotropic support, and sepsis rates were significantly high in the AKI group.Hospitalization day among survivors was longer and mortality was higher in the AKI group than the non-AKI group (p=0.042,p < 0.0001 respectively).CONCLUSION: The neonatal KDIGO criteria are beneficial and also informative in diagnosing and staging AKI.Close follow-up of urine output and creatinine levels especially in the first days is essential in very preterm infants,