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Prognostic role of acute kidney injury on long-term outcome in infants with hypoxic-ischemic encephalopathy.
- Source :
-
Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2020 Mar; Vol. 35 (3), pp. 477-483. Date of Electronic Publication: 2019 Dec 11. - Publication Year :
- 2020
-
Abstract
- Background: The objective of this study was to evaluate the prognostic role of postnatal acute kidney injury (AKI) on neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH).<br />Methods: This is a prospective observational study including all neonates with HIE receiving TH between 2009 and 2016 at a single center. AKI was classified according to the Kidney Disease: Improving Global Outcomes definition modified for neonatal age. Child development was assessed using the Griffiths Mental Development Scales (GMDS). Study outcome was defined as unfavorable outcome (including death or disability according to GMDS) or favorable otherwise, at 12 and 24 months.<br />Results: One-hundred and one neonates (median gestational age 39 weeks) were included. AKI was diagnosed in 10 neonates (10%). Seven patients died within the first year, 35 patients had disability at 12 months, and 45 patients at 24 months. AKI was associated with increased likelihood of unfavorable outcome at 24 months (100% vs. 59% in neonates without AKI; pā=ā0.01). AKI showed good positive predictive value (1.00, 95% CI 0.71-1.00) and specificity (1.00, 95% CI 0.88-1.00), but poor negative predictive value (0.41, 95% CI 0.30-0.52) and sensitivity (0.19, 95% CI 0.11-0.32) at 24 months.<br />Conclusions: AKI might be a reliable indicator of death or long-term disability in infants with HIE receiving TH, but the absence of AKI does not guarantee a favorable long-term outcome.
- Subjects :
- Acute Kidney Injury blood
Acute Kidney Injury diagnosis
Acute Kidney Injury etiology
Asphyxia Neonatorum physiopathology
Asphyxia Neonatorum therapy
Creatinine blood
Female
Humans
Hypothermia, Induced
Hypoxia-Ischemia, Brain etiology
Hypoxia-Ischemia, Brain mortality
Hypoxia-Ischemia, Brain therapy
Infant
Infant, Newborn
Length of Stay
Male
Neurodevelopmental Disorders etiology
Neurodevelopmental Disorders physiopathology
Prognosis
Prospective Studies
Risk Assessment methods
Risk Factors
Treatment Outcome
Acute Kidney Injury epidemiology
Asphyxia Neonatorum complications
Child Development physiology
Hypoxia-Ischemia, Brain physiopathology
Neurodevelopmental Disorders epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1432-198X
- Volume :
- 35
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Pediatric nephrology (Berlin, Germany)
- Publication Type :
- Academic Journal
- Accession number :
- 31828471
- Full Text :
- https://doi.org/10.1007/s00467-019-04406-4