ArticlePediatric research2023
Gestational age-specific clinical correlates of acute kidney injury in preterm infants with necrotizing enterocolitis.
Article in Pediatric research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- A Pathophysiological Approach for Early Detection and Prevention of AKI in the NICU.American journal of perinatology · 2026Review
- Understanding the Impact of Patent Ductus Arteriosus and Treatment Strategies on Acute Kidney Injury in Preterm Infants.American journal of perinatology · 2026Review
- Tight junction proteins and intestinal health in preterm infants.Journal of neonatal-perinatal medicine · 2025Review
- Selenium deficiency is functionally linked with the molecular etiopathogenesis of necrotizing enterocolitis (NEC).Functional & integrative genomics · 2025Article
- Necrotizing Enterocolitis-Associated Acute Kidney Injury-Transforming the Paradigm.American journal of perinatology · 2025Review
- Hypotension: a modifiable risk factor impacting surgical NEC-associated AKI and brain injury in preterm infants.Pediatric research · 2024Article
- Perinatal risk factors associated with acute kidney injury severity and duration among infants born extremely preterm.Pediatric research · 2024Article
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundTo study the gestational age-specific risk factors and outcomes of severe acute kidney injury (AKI) in neonates with necrotizing enterocolitis (NEC).
methodsRetrospective cohort study comparing gestational age (GA)-specific clinical data between infants without severe AKI (stage 0/1 AKI) and those with severe AKI (stages 2 and 3 AKI) stratified by GA ≤27 and >27 weeks.
resultsInfants with GA ≤27 weeks had double the rate of severe AKI (46.3% vs. 20%). In infants with GA >27 weeks, male sex, outborn, and nephrotoxic medication exposure were associated with severe AKI. On multivariable logistic regression, in infants with GA ≤27 weeks, surgical NEC (OR 35.08 (CI 5.05, 243.73), p < 0.001) and ostomy (OR 6.2(CI 1.29, 29.73), p = 0.027) were associated with significantly higher odds of severe AKI. Surgical NEC infants with GA >27 weeks and severe AKI were significantly more likely to be outborn, have later NEC onset, need dopamine, and have longer hospitalization (158 days [110; 220] vs.75.5 days [38.8; 105]; p = 0.007 than those with non-severe AKI.
conclusionIn neonates with NEC, surgical intervention was associated with moderate-to-severe AKI in infants with GA ≤27 weeks and with longer hospitalization in infants with GA >27 weeks. IMPACT: In both cohorts need for surgery, stoma, cholestasis, and mechanical ventilation were associated with severe AKI; however, the infants with GA <27 weeks had twice the risk of severe AKI than GA >27 weeks group. The longer exposure to nephrotoxic medication and referral need were significant risk factors for AKI in GA >27 weeks group. GA-specific kidney protective and monitoring strategies to prevent AKI and its consequences are needed to improve the clinical outcomes in neonates with NEC. Understanding the risk factors and short- and long-term outcomes unique to different GA groups will help inform those strategies.
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