ArticlePediatric nephrology (Berlin, Germany)2018
Acute kidney injury in necrotizing enterocolitis predicts mortality.
Article in Pediatric nephrology (Berlin, Germany), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Developing a prioritized research agenda for necrotizing enterocolitis.Journal of perinatology : official journal of the California Perinatal Association · 2026Pooled it
- Clinical Characteristics of Necrotizing Enterocolitis Diagnosed by Independent Adjudication of Abdominal Radiographs, Laparotomy, or Autopsy in Preterm Infants in the "Connection Trial".American journal of perinatology · 2025Trial
- A Pathophysiological Approach for Early Detection and Prevention of AKI in the NICU.American journal of perinatology · 2026Review
- Incidence, Predictors, and Outcomes Associated with Recurrent Neonatal Acute Kidney Injury in Preterm Infants: A Secondary Analysis of the Preterm Erythropoietin Neuroprotection Trial (PENUT).Research square · 2026Article
- Prognostic value of modified KDIGO staging for acute kidney injury in neonates: a prospective observational study in a level IIIB NICU.BMC pediatrics · 2026Observational
- Interpretable machine learning for the early prediction of acute kidney injury in preterm infants in the neonatal intensive care unit.Renal failure · 2025Article
- Acute kidney injury in infants with necrotising enterocolitis: A case-control study.European journal of pediatrics · 2025Article
- Effect of serum creatinine changes on surgical timing and prognosis in progressive necrotizing Enterocolitis.BMC pediatrics · 2025Article
- Necrotizing Enterocolitis-Associated Acute Kidney Injury-Transforming the Paradigm.American journal of perinatology · 2025Review
- Timing and risk factors associated with acute kidney injury in infants with necrotizing enterocolitis.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Advocating for the inclusion of kidney health outcomes in neonatal research: best practice recommendations by the Neonatal Kidney Collaborative.Journal of perinatology : official journal of the California Perinatal Association · 2024Review
- Perinatal risk factors associated with acute kidney injury severity and duration among infants born extremely preterm.Pediatric research · 2024Article
- Recurrent neonatal acute kidney injury: incidence, predictors, and outcomes in the neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Perinatal risk factors for late neonatal severe acute kidney injury in very low birth weight infants: a retrospective study.Frontiers in pediatrics · 2024Article
- Article
- Gestational age-specific clinical correlates of acute kidney injury in preterm infants with necrotizing enterocolitis.Pediatric research · 2023Article
- Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Acute kidney injury post-abdominal surgery in infants: implications for prevention and management.Frontiers in pediatrics · 2023Review
- Association between acute kidney injury and brain injury on term-equivalent age brain magnetic resonance imaging in very preterm infants.Pediatric nephrology (Berlin, Germany) · 2022Article
- Clinical impact of severe acute kidney injury on post-operative and brain injury outcomes in preterm infants following surgical necrotizing enterocolitis.The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMorbidity and mortality with necrotizing enterocolitis (NEC) remains a significant challenge. Acute kidney injury (AKI) has been shown to worsen survival in critically ill neonates. To our knowledge, this study is the first to evaluate the prevalence of AKI and its impact on outcomes in neonatal NEC.
methodsWe carried out a single-center retrospective chart review of all neonates treated for NEC between 2003 and 2015 (N = 181). AKI is defined as a rise in serum creatinine (SCr) from a previous trough according to neonatal modified KDIGO criteria (stage 1 = SCr rise 0.3 mg/dL or SCr 150 < 200%, stage 2 = SCr rise 200 < 300%, stage 3 = SCr rise ≥300%, SCr 2.5 mg/dL or dialysis). Primary outcome was in-hospital mortality and secondary outcomes were hospital length of stay (LOS) and need for and type of surgery.
resultsAcute kidney injury occurred in 98 neonates (54%), with 39 stage 1 (22%), 31 stage 2 (18%), and 28 stage 3 (16%), including 5 requiring dialysis. Non-AKI and AKI groups were not statistically different in age, weight, Bell's NEC criteria, and medication exposure (vasopressors, vancomycin, gentamicin, or diuretic). Neonates with AKI had higher mortality (44% vs 25.6%, p = 0.008) and a higher chance of death (HR 2.4, CI 1.2-4.8, p = 0.009), but the effect on LOS on survivors did not reach statistical significance (79 days, interquartile range [IQR] 30-104 vs 54 days, IQR 30-92, p = 0.09). Overall, 48 (27.9%) patients required surgical intervention.
conclusionsThis study shows that AKI not only occurs in over half of patients with NEC, but that it is also associated with more than a two-fold higher mortality, highlighting the importance of early recognition and potentially early intervention for AKI.
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