Acute Kidney Injury Associated with Late-Onset Neonatal Sepsis: A Matched Cohort Study - 22/03/21
Abstract |
Objectives |
To determine incidence and severity of acute kidney injury (AKI) within 7 days of sepsis evaluation and to assess AKI duration and the association between AKI and 30-day mortality.
Study design |
Retrospective, matched cohort study in a single-center level IV neonatal intensive care unit. Eligible infants underwent sepsis evaluations at ≥72 hours of age during calendar years 2013-2018. Exposed infants (cases) were those with culture-proven sepsis and antimicrobial duration ≥5 days. Nonexposed infants (controls) were matched 1:1 to exposed infants based on gestational and corrected gestational age, and had negative sepsis evaluations with antibiotic durations <48 hours. AKI was defined by modified neonatal Kidney Disease Improving Global Outcomes criteria. Statistical analysis included Mann-Whitney and χ2 tests, multivariable logistic regression, and Kaplan-Meier time-to-event analysis.
Results |
Among 203 episodes of late-onset sepsis, 40 (20%) developed AKI within 7 days after evaluation, and among 193 episodes with negative cultures, 16 (8%) resulted in AKI (P = .001). Episodes of sepsis also led to greater AKI severity, compared with nonseptic episodes (P = .007). The timing of AKI onset and AKI duration did not differ between groups. Sepsis was associated with increased odds of developing AKI (aOR, 3.0; 95% CI, 1.5-6.2; P = .002). AKI was associated with increased 30-day mortality (aOR, 4.5; 95% CI, 1.3-15.6; P = .017).
Conclusions |
Infants with late-onset sepsis had increased odds of AKI and greater AKI severity within 7 days of sepsis evaluation, compared with age-matched infants without sepsis. AKI was independently associated with increased 30-day mortality. Strategies to mitigate AKI in critically ill neonates with sepsis may improve outcomes.
Le texte complet de cet article est disponible en PDF.Keywords : infant, preterm, neonatal intensive care unit, sepsis, acute kidney injury
Abbreviations : AKI, ECMO, NEC, NICU, nKDIGO
Plan
Development of the neonatal sepsis registry is supported by CareFusion, Inc., and the Institute for Biomedical Informatics, University of Pennsylvania School of Medicine. The authors declare no conflicts of interest. |
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Abstracts accepted to the 2020 meetings of the Eastern Society for Pediatric Research and the Pediatric Academic Societies annual meetings; presentations cancelled owing to the COVID-19 pandemic. |
Vol 231
P. 185 - avril 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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