ArticleThe Lancet. Child & adolescent health2017
Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study.
Article in The Lancet. Child & adolescent health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 412 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates
Pharmacokinetics (PK) and Safety of Caffeine in Neonates With Hypoxic Ischemic Encephalopathy Receiving Therapeutic Hypothermia
Predicting Acute Kidney Injury in Infants Exposed to Nephrotoxic Drugs: A Big Data Approach to Predict NEOnatal Acute Kidney Injury in Newborns expoSed to nephroTOxic Drugs. (NeoAKI STOP)
Incidence of Acute Kidney Injury and Risk Factors in Newborns With Congenital Diaphragmatic Hernia
Who cites it
412 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Growth after pediatric and neonatal acute kidney injury: a meta-analysis.Pediatric nephrology (Berlin, Germany) · 2025Pooled it
- Acute kidney injury magnitude, mortality, and associated factors among neonates in sub-Saharan Africa: a systematic review and meta-analysis.Pediatric nephrology (Berlin, Germany) · 2025Pooled it
- Risk Factors for Nephrotoxicity Among Neonates Receiving Vancomycin: A Systematic Review and Meta-analysis.Paediatric drugs · 2025Pooled it
- Incidence of acute kidney injury-associated mortality in hospitalized children: a systematic review and meta-analysis.BMC nephrology · 2025Pooled it
- The application of machine learning in predicting post-cardiac surgery acute kidney injury in pediatric patients: a systematic review.Frontiers in pediatrics · 2025Pooled it
- Risk factors for acute kidney injury in very-low birth weight newborns: a systematic review with meta-analysis.European journal of pediatrics · 2024Pooled it
- Elevated serum creatinine over the first week of life and mortality risk in extremely preterm neonates: a secondary analysis of the Preterm Erythropoietin Neuroprotection Trial (PENUT).Pediatric nephrology (Berlin, Germany) · 2026Trial
- High versus standard dose caffeine in prevention of apnea of prematurity: an assessor-blinded randomized controlled trial (HI-CAF trial).European journal of pediatrics · 2026Trial
- Acute Kidney Injury and Neurodevelopmental Outcomes in Extremely Premature Neonates: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2025Trial
- Acute kidney injury and subsequent risk of late-onset infection among extremely low gestational age newborns.Journal of perinatology : official journal of the California Perinatal Association · 2025Trial
- Trial
- Improving pediatric post-acute kidney injury care: considerations for the clinician.Renal failure · 2026Review
- Impact of maternal health on neonatal and long-term kidney outcomes.Pediatric nephrology (Berlin, Germany) · 2026Review
- Time to diagnosis of acute kidney injury and its predictors among outborn neonates in India: a competing-risk analysis of tele-ICU network data (2022-2024).The Lancet regional health. Southeast Asia · 2026Article
- Urinary neutrophil gelatinase-associated lipocalin concentration: a baseline study for establishing reference ranges in preterm neonates.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- STARZ Scoring in Very Low Birth Weight (VLBW) neonates: validation and risk-stratification for neonatal acute kidney injury.Pediatric research · 2026Article
- Discovery urinary metabolomics of preterm neonatal acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2026Observational
- A Pathophysiological Approach for Early Detection and Prevention of AKI in the NICU.American journal of perinatology · 2026Review
- Neonatal acute kidney injury and the patent ductus arteriosus.Pediatric nephrology (Berlin, Germany) · 2026Review
- TIMP-2 and IGFBP7 for the differentiation of functional and intrinsic pediatric acute kidney injury.Pediatric research · 2026Article
352 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
Background: Single-center studies suggest that neonatal acute kidney injury (AKI) is associated with poor outcomes. However, inferences regarding the association between AKI, mortality, and hospital length of stay are limited due to the small sample size of those studies. In order to determine whether neonatal AKI is independently associated with increased mortality and longer hospital stay, we analyzed the Assessment of Worldwide Acute Kidney Epidemiology in Neonates (AWAKEN) database. Methods: All neonates admitted to 24 participating neonatal intensive care units from four countries (Australia, Canada, India, United States) between January 1 and March 31, 2014, were screened. Of 4273 neonates screened, 2022 (47·3%) met study criteria. Exclusion criteria included: no intravenous fluids ≥48 hours, admission ≥14 days of life, congenital heart disease requiring surgical repair at <7 days of life, lethal chromosomal anomaly, death within 48 hours, inability to determine AKI status or severe congenital kidney abnormalities. AKI was defined using a standardized definition -i.e., serum creatinine rise of ≥0.3 mg/dL (26.5 mcmol/L) or ≥50% from previous lowest value, and/or if urine output was <1 mL/kg/h on postnatal days 2 to 7. Findings: Incidence of AKI was 605/2022 (29·9%). Rates varied by gestational age groups (i.e., ≥22 to <29 weeks =47·9%; ≥29 to <36 weeks =18·3%; and ≥36 weeks =36·7%). Even after adjusting for multiple potential confounding factors, infants with AKI had higher mortality compared to those without AKI [(59/605 (9·7%) vs. 20/1417 (1·4%); p< 0.001; adjusted OR=4·6 (95% CI=2·5-8·3); p=<0·0001], and longer hospital stay [adjusted parameter estimate 8·8 days (95% CI=6·1-11·5); p<0·0001]. Interpretation: Neonatal AKI is a common and independent risk factor for mortality and longer hospital stay. These data suggest that neonates may be impacted by AKI in a manner similar to pediatric and adult patients. Funding: US National Institutes of Health, University of Alabama at Birmingham, Cincinnati Children's, University of New Mexico.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.