ArticlePediatric nephrology (Berlin, Germany)2024
Use of furosemide in preterm neonates with acute kidney injury is associated with increased mortality: results from the TINKER registry.
Article in Pediatric nephrology (Berlin, Germany), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 3 citations in OpenAlex.
- Validation of STARZ scoring in very low birth weight (VLBW) neonates in the United States.Pediatric research · 2026Article
- Population Pharmacokinetics and Exposure-Safety Analysis of Furosemide in Preterm Infants.Journal of clinical pharmacology · 2026Article
- Stealing nephrons-a review on how patent ductus arteriosus physiology impacts neonatal kidney health.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Artificial intelligence and pediatric acute kidney injury: a mini-review and white paper.Frontiers in nephrology · 2025Review
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Authors and funding
20 authors at 17 institutions in 4 countries.
Funding
Abstract
backgroundDiuretics are commonly used in neonatal AKI with the rationale to decrease positive fluid balance in critically sick neonates. The patterns of furosemide use vary among hospitals, which necessitates the need for a well-designed study.
methodsThe TINKER (The Indian Iconic Neonatal Kidney Educational Registry) study provides a database, spanning 14 centres across India since August 2018. Admitted neonates (≤ 28 days) receiving intravenous fluids for at least 48 h were included. Neonatal KDIGO criteria were used for the AKI diagnosis. Detailed clinical and laboratory parameters were collected, including the indications of furosemide use, detailed dosing, and the duration of furosemide use (in days).
resultsA total of 600 neonates with AKI were included. Furosemide was used in 8.8% of the neonates (53/600). Common indications of furosemide use were significant cardiac disease, fluid overload, oliguria, BPD, RDS, hypertension, and hyperkalemia. The odds of mortality was higher in neonates < 37 weeks gestational age with AKI who received furosemide compared to those who did not receive furosemide 3.78 [(1.60-8.94); p = 0.003; univariate analysis] and [3.30 (1.11-9.82); p = 0.03]; multivariate logistic regression].
conclusionsIn preterm neonates with AKI, mortality was independently associated with furosemide treatment. The furosemide usage rates were higher in neonates with associated co-morbidities, i.e. significant cardiac diseases or surgical interventions. Sicker babies needed more resuscitation at birth, and died early, and hence needed shorter furosemide courses. Thus, survival probability was higher in neonates treated with long furosemide courses vs. short courses.
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