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- Title
Trends and racial disparities for acute kidney injury in premature infants: the US national database.
- Authors
Elgendy, Marwa M.; Othman, Hasan F.; Younis, Mira; Puthuraya, Subhash; Matar, Raed Bou; Aly, Hany
- Abstract
Background: To assess prevalence and outcomes of acute kidney injury (AKI) in very-low-birth-weight infants. Methods: This cross-sectional study utilized the National Inpatient Sample (NIS) dataset for years 2000–2017. All premature infants with birth weight (BW) <1500g and/or gestational age (GA) ≤32 weeks were included. Analyses were conducted for overall population and two BW categories: <1000g and 1000–1499g. Adjusted odds ratios were calculated after controlling for confounding variables in logistic regression analysis. Cochrane–Armitage test was used to assess for statistically significant trends in AKI frequency over the years. Results: In total, 1,311,681 hospitalized premature infants were included; 19,603 (1.5%) were diagnosed with AKI. The majority (74.3%) were BW <1000g and 63.9% ≤28 weeks gestation. Prevalence of AKI differed by ethnicity; White had significantly less AKI than Black (OR=0.79, p<0.001) and Hispanic (OR=0.83, p<0.001). AKI was significantly associated with higher mortality compared to controls (35.1 vs. 3.0%, p<0.001). AKI was associated with comorbidities such as necrotizing enterocolitis, patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage, and septicemia. In a regression model, AKI was associated with higher mortality after controlling confounding factors (aOR=7.79, p<0.001). AKI was associated with significant increase in length of stay (p<0.001) and cost of hospitalization in survivors (p<0.001). There is a significant trend for increased AKI frequency over the years (Z score=4.33, p<0.001). Conclusion: AKI is associated with increased mortality and comorbidities in preterm infants, especially in infants with BW <1000g. Further studies are needed to understand precipitating factors and assess preventative measures for this serious complication.
- Subjects
UNITED States; NEONATAL necrotizing enterocolitis; LENGTH of stay in hospitals; PATENT ductus arteriosus; CEREBRAL hemorrhage; CROSS-sectional method; VERY low birth weight; RACE; MEDICAL care costs; TREATMENT effectiveness; SEPSIS; DESCRIPTIVE statistics; HOSPITAL care; HEALTH equity; ODDS ratio; LOGISTIC regression analysis; BRONCHOPULMONARY dysplasia; ACUTE kidney failure; COMORBIDITY; EVALUATION; DISEASE complications; CHILDREN
- Publication
Pediatric Nephrology, 2021, Vol 36, Issue 9, p2789
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-021-04998-w