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Acute kidney injury in infants with hypoxic-ischemic encephalopathy

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Abstract

Background

This study aimed to investigate the prevalence of acute kidney injury (AKI) in infants with varying degrees of hypoxic-ischemic encephalopathy (HIE) and its associated outcomes, including mortality and length of stay (LOS).

Methods

The study used the National Inpatient Sample (NIS) dataset from 2010 to 2018. Regression analysis was used to control confounding variables.

Results

Of 31,220,784 infants included in the study, 30,130 (0.1%) had HIE. The prevalence of AKI was significantly higher in infants with HIE (9.0%) compared to those without (0.04%), with an adjusted odds ratio (aOR) of 77.6 (CI:70.1–85.7, p < 0.001), with the highest prevalence of AKI in infants with severe HIE (19.7%), aOR:130 (CI: 107–159), p < 0.001). Infants with AKI had a higher mortality rate compared to those without AKI in those diagnosed with any degree of HIE (28.9% vs. 8.8%), aOR 3.5 (CI: 3.2–3.9, p < 0.001), particularly among those with severe HIE, aOR:1.4 (1.2–1.6, p < 0.001).

Conclusions

HIE is associated with an increased prevalence of AKI. Infants with severe HIE had the highest prevalence of AKI and associated mortality. The study highlights the need for close monitoring and early detection of AKI in infants with HIE, particularly those with severe HIE, to ameliorate the associated adverse outcomes.

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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

AKI:

Acute kidney injury

BW:

Birth weight

CDH:

Congenital diaphragmatic hernia

CHD:

Congenital heart disease

GA:

Gestational age

HIE:

Hypoxic-ischemic encephalopathy

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Funding

Authors have no financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. Department of Pediatrics & Neonatology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA

    Marwa M. Elgendy

  2. Division of Neonatology, University of Florida College of Medicine – Jacksonville, Jacksonville, FL, USA

    Josef Cortez

  3. Department of Neonatology, Cleveland Clinic Children’s, Cleveland, OH, USA

    Firas Saker, Ceyda Acun, Mohamed A. Mohamed & Hany Aly

  4. Center for Pediatric Nephrology, Cleveland Clinic Children’s, Cleveland, OH, USA

    Raed Bou Matar

Authors
  1. Marwa M. Elgendy
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  2. Josef Cortez
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  3. Firas Saker
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  4. Ceyda Acun
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  5. Raed Bou Matar
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  6. Mohamed A. Mohamed
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  7. Hany Aly
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Contributions

Drs. Elgendy, Mohamed, and Aly participated in the conception and design of the work, including the acquisition, analysis, and interpretation of the statistical analyses, drafting the initial manuscript, and reviewing and revising the manuscript. They coordinated, supervised data collection, and critically reviewed the manuscript for important intellectual content.

Drs. Cortez, Saker, and Acun conceptualized and designed the study, carried out the initial analyses, drafted the work, and critically reviewed the manuscript for important intellectual content. Dr. Bou Matar reviewed the results and statistical work; he critically reviewed, edited, and approved the final version of the manuscript.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Marwa M. Elgendy.

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Mohamed A. Mohamed and Hany Aly have joint senior authorship.

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Elgendy, M.M., Cortez, J., Saker, F. et al. Acute kidney injury in infants with hypoxic-ischemic encephalopathy. Pediatr Nephrol 39, 1271–1277 (2024). https://doi.org/10.1007/s00467-023-06214-3

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  • DOI: https://doi.org/10.1007/s00467-023-06214-3

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