Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation

Michelle C. Starr; Louis Boohaker; Laurie C. Eldredge; Shina Menon; Russell Griffin; Dennis E. Mayock; Linzi Li; David Askenazi; Sangeeta Hingorani; Namasivayam Ambalavanan; David T. Selewski; Subrata Sarkar; Alison Kent; Jeffery Fletcher; Carolyn L. Abitbol; Marissa Defreitas; Shahnaz Duara; Jennifer R. Charlton; Jonathan R. Swanson; Ronnie Guillet; Carl D'Angio; Ayesa Mian; Erin Rademacher; Maroun J. Mhanna; Rupesh Raina; Deepak Kumar; Jennifer G. Jetton; Patrick D. Brophy; Tarah T. Colaizy; Jonathan M. Klein; Ayse Akcan Arikan; Christopher J. Rhee; Stuart L. Goldstein; Amy T. Nathan; Juan C. Kupferman; Alok Bhutada; Shantanu Rastogi; Elizabeth Bonachea; John Mahan; F. Sessions Cole; T. Keefe Davis; Joshua Dower; Lawrence Milner; Alexandra Smith; Mamta Fuloria; Kimberly Reidy; Frederick J. Kaskel; Danielle E. Soranno; Jason Gien; Katja M. Gist; Aftab S. Chishti; Mina H. Hanna; Craig S. Wong; Catherine Joseph; Tara Dupont; Robin Ohls; Amy Staples; Surender Khokhar; Sofia Perazzo; Patricio E. Ray; Mary Revenis; Sidharth K. Sethi; Smriri Rohatgi; Cherry Mammen; Anne Synnes; Sanjay Wazir; Pia Wintermark; Robert Woroniecki; Shanty Sridhar; Susan Ingraham; Arwa Nada; Michael Zappitelli

doi:10.1055/s-0039-3400311

Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation

Michelle C. Starr
, Louis Boohaker
, Laurie C. Eldredge
, Shina Menon
, Russell Griffin
, Dennis E. Mayock
, Linzi Li
, David Askenazi
, Sangeeta Hingorani
, Namasivayam Ambalavanan
, David T. Selewski
, Subrata Sarkar
, Alison Kent
, Jeffery Fletcher
, Carolyn L. Abitbol
, Marissa Defreitas
, Shahnaz Duara
, Jennifer R. Charlton
, Jonathan R. Swanson
, Ronnie Guillet

Carl D'Angio, Ayesa Mian, Erin Rademacher, Maroun J. Mhanna, Rupesh Raina, Deepak Kumar, Jennifer G. Jetton, Patrick D. Brophy, Tarah T. Colaizy, Jonathan M. Klein, Ayse Akcan Arikan, Christopher J. Rhee, Stuart L. Goldstein, Amy T. Nathan, Juan C. Kupferman, Alok Bhutada, Shantanu Rastogi, Elizabeth Bonachea, John Mahan, F. Sessions Cole, T. Keefe Davis, Joshua Dower, Lawrence Milner, Alexandra Smith, Mamta Fuloria, Kimberly Reidy, Frederick J. Kaskel, Danielle E. Soranno, Jason Gien, Katja M. Gist, Aftab S. Chishti, Mina H. Hanna, Craig S. Wong, Catherine Joseph, Tara Dupont, Robin Ohls, Amy Staples, Surender Khokhar, Sofia Perazzo, Patricio E. Ray, Mary Revenis, Sidharth K. Sethi, Smriri Rohatgi, Cherry Mammen, Anne Synnes, Sanjay Wazir, Pia Wintermark, Robert Woroniecki, Shanty Sridhar, Susan Ingraham, Arwa Nada, Michael Zappitelli

Pediatrics

Research output: Contribution to journal › Article › peer-review

52 Scopus citations

Abstract

Objective This study aimed to evaluate the association between acute kidney injury (AKI) and bronchopulmonary dysplasia (BPD) in infants born <32 weeks of gestational age (GA). Study Design Present study is a secondary analysis of premature infants born at <32 weeks of GA in the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) retrospective cohort (n = 546). We stratified by gestational age and used logistic regression to determine association between AKI and moderate or severe BPD/mortality. Results Moderate or severe BPD occurred in 214 of 546 (39%) infants, while death occurred in 32 of 546 (6%); the composite of moderate or severe BPD/death occurred in 246 of 546 (45%). For infants born ≤29 weeks of gestation, the adjusted odds ratio (OR) of AKI and the primary outcome was 1.15 (95% confidence interval [CI] = 0.47-2.86; p = 0.76). Infants born between 29 and 32 weeks of gestation with AKI had four-fold higher odds of moderate or severe BPD/death that remained after controlling for multiple factors (adjusted OR = 4.21, 95% CI: 2.07-8.61; p < 0.001). Conclusion Neonates born between 29 and 32 weeks who develop AKI had a higher likelihood of moderate or severe BPD/death than those without AKI. Further studies are needed to validate our findings and evaluate mechanisms of multiorgan injury.

Original language	English
Pages (from-to)	341-348
Number of pages	8
Journal	American Journal of Perinatology
Volume	37
Issue number	3
DOIs	https://doi.org/10.1055/s-0039-3400311
State	Published - Feb 1 2020

Bibliographical note

Publisher Copyright:
© 2020 Thieme Medical Publishers, Inc.. All rights reserved.

Funding

All authors report no real or perceived conflicts of interest that could affect the study design, collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the manuscript for publication. This study was supported by the NIH U01NS077953 (L.B., R.G., Cincinnati Children’s Hospital Center for Acute Care Nephrology provided funding to create and maintain the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) study Medidata Rave electronic database. The Pediatric and Infant Center for Acute Nephrology (PICAN) provided support for web meetings and for the Neonatal Kidney Collaborative (NKC) steering committee annual meeting at The University of Alabama at Birmingham (UAB), as well as support for two of the AWAKEN study investigators at UAB (D.A., R.G., and L.B.). PICAN is part of the Department of Pediatrics at UAB and is funded by Children’s of Alabama hospital, UAB Department of Pediatrics, UAB School of Medicine, and UAB Center for Clinical and Translational Sciences (National Institutes of Health grant UL1TR001417). Finally, the AWAKEN study at The University of New Mexico was supported by the Clinical and Translational Science Center at The University of New Mexico (National Institutes of Health grant UL1TR001449) and by The University of Iowa Institute for Clinical and Translational Science (grant U54TR001356). The AWAKEN study investigators at the Canberra Hospital at the Australian National University Medical School were supported by the Canberra Hospital Private Practice Fund, and investigators at University of Virginia Children’s Hospital were supported by a 100 Women Who Care Grant from the 100 Women Charitable Foundation. The funding sources for this study had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. L.L., and D.A.) and T32DK007662 (MS). For full disclosure, we provide the additional list of authors’ other commitments and funding sources that are not directly related to this study. D.A. reports serving on the speaker board for Baxter and for the Acute Kidney Injury Foundation; he also reported receiving grant funding for studies not related to this work, grant R01 DK103608 from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases, and grant R01 FD005092 from the National Institutes of Health/US Food and Drug Administration. S.G. reports receiving grant funding for studies not related to this work, grant R01 DK103608 from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases. No other disclosures were reported.

Funders	Funder number
100 Women Charitable Foundation
Children’s Hospital of Alabama
National Institutes of Health and Food and Drug Administration
UAB Center for Clinical and Translational Sciences
University of Iowa Institute for Clinical and Translational Science	U54TR001356
National Institutes of Health (NIH)	U01NS077953, UL1TR001417
National Institute of Diabetes and Digestive and Kidney Diseases	R01 FD005092
National Center for Advancing Translational Sciences (NCATS)	UL1TR001449
New Mexico State University, New York University
University of Alabama, Birmingham

Keywords

acute lung injury
acute renal failure
bronchopulmonary dysplasia
chronic lung disease
neonate
organ crosstalk
prematurity

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

Access to Document

10.1055/s-0039-3400311

Cite this

Starr, M. C., Boohaker, L., Eldredge, L. C., Menon, S., Griffin, R., Mayock, D. E., Li, L., Askenazi, D., Hingorani, S., Ambalavanan, N., Selewski, D. T., Sarkar, S., Kent, A., Fletcher, J., Abitbol, C. L., Defreitas, M., Duara, S., Charlton, J. R., Swanson, J. R., ... Zappitelli, M. (2020). Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation. American Journal of Perinatology, 37(3), 341-348. https://doi.org/10.1055/s-0039-3400311

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title = "Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation",

abstract = "Objective This study aimed to evaluate the association between acute kidney injury (AKI) and bronchopulmonary dysplasia (BPD) in infants born <32 weeks of gestational age (GA). Study Design Present study is a secondary analysis of premature infants born at <32 weeks of GA in the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) retrospective cohort (n = 546). We stratified by gestational age and used logistic regression to determine association between AKI and moderate or severe BPD/mortality. Results Moderate or severe BPD occurred in 214 of 546 (39\%) infants, while death occurred in 32 of 546 (6\%); the composite of moderate or severe BPD/death occurred in 246 of 546 (45\%). For infants born ≤29 weeks of gestation, the adjusted odds ratio (OR) of AKI and the primary outcome was 1.15 (95\% confidence interval [CI] = 0.47-2.86; p = 0.76). Infants born between 29 and 32 weeks of gestation with AKI had four-fold higher odds of moderate or severe BPD/death that remained after controlling for multiple factors (adjusted OR = 4.21, 95\% CI: 2.07-8.61; p < 0.001). Conclusion Neonates born between 29 and 32 weeks who develop AKI had a higher likelihood of moderate or severe BPD/death than those without AKI. Further studies are needed to validate our findings and evaluate mechanisms of multiorgan injury.",

keywords = "acute lung injury, acute renal failure, bronchopulmonary dysplasia, chronic lung disease, neonate, organ crosstalk, prematurity",

author = "Starr, \{Michelle C.\} and Louis Boohaker and Eldredge, \{Laurie C.\} and Shina Menon and Russell Griffin and Mayock, \{Dennis E.\} and Linzi Li and David Askenazi and Sangeeta Hingorani and Namasivayam Ambalavanan and Selewski, \{David T.\} and Subrata Sarkar and Alison Kent and Jeffery Fletcher and Abitbol, \{Carolyn L.\} and Marissa Defreitas and Shahnaz Duara and Charlton, \{Jennifer R.\} and Swanson, \{Jonathan R.\} and Ronnie Guillet and Carl D'Angio and Ayesa Mian and Erin Rademacher and Mhanna, \{Maroun J.\} and Rupesh Raina and Deepak Kumar and Jetton, \{Jennifer G.\} and Brophy, \{Patrick D.\} and Colaizy, \{Tarah T.\} and Klein, \{Jonathan M.\} and Arikan, \{Ayse Akcan\} and Rhee, \{Christopher J.\} and Goldstein, \{Stuart L.\} and Nathan, \{Amy T.\} and Kupferman, \{Juan C.\} and Alok Bhutada and Shantanu Rastogi and Elizabeth Bonachea and John Mahan and Cole, \{F. Sessions\} and Davis, \{T. Keefe\} and Joshua Dower and Lawrence Milner and Alexandra Smith and Mamta Fuloria and Kimberly Reidy and Kaskel, \{Frederick J.\} and Soranno, \{Danielle E.\} and Jason Gien and Gist, \{Katja M.\} and Chishti, \{Aftab S.\} and Hanna, \{Mina H.\} and Wong, \{Craig S.\} and Catherine Joseph and Tara Dupont and Robin Ohls and Amy Staples and Surender Khokhar and Sofia Perazzo and Ray, \{Patricio E.\} and Mary Revenis and Sethi, \{Sidharth K.\} and Smriri Rohatgi and Cherry Mammen and Anne Synnes and Sanjay Wazir and Pia Wintermark and Robert Woroniecki and Shanty Sridhar and Susan Ingraham and Arwa Nada and Michael Zappitelli",

year = "2020",

month = feb,

day = "1",

doi = "10.1055/s-0039-3400311",

language = "English",

volume = "37",

pages = "341--348",

number = "3",

}

Starr, MC, Boohaker, L, Eldredge, LC, Menon, S, Griffin, R, Mayock, DE, Li, L, Askenazi, D, Hingorani, S, Ambalavanan, N, Selewski, DT, Sarkar, S, Kent, A, Fletcher, J, Abitbol, CL, Defreitas, M, Duara, S, Charlton, JR, Swanson, JR, Guillet, R, D'Angio, C, Mian, A, Rademacher, E, Mhanna, MJ, Raina, R, Kumar, D, Jetton, JG, Brophy, PD, Colaizy, TT, Klein, JM, Arikan, AA, Rhee, CJ, Goldstein, SL, Nathan, AT, Kupferman, JC, Bhutada, A, Rastogi, S, Bonachea, E, Mahan, J, Cole, FS, Davis, TK, Dower, J, Milner, L, Smith, A, Fuloria, M, Reidy, K, Kaskel, FJ, Soranno, DE, Gien, J, Gist, KM, Chishti, AS , Hanna, MH, Wong, CS, Joseph, C, Dupont, T, Ohls, R, Staples, A, Khokhar, S, Perazzo, S, Ray, PE, Revenis, M, Sethi, SK, Rohatgi, S, Mammen, C, Synnes, A, Wazir, S, Wintermark, P, Woroniecki, R, Sridhar, S, Ingraham, S, Nada, A & Zappitelli, M 2020, 'Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation', American Journal of Perinatology, vol. 37, no. 3, pp. 341-348. https://doi.org/10.1055/s-0039-3400311

TY - JOUR

T1 - Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation

AU - Starr, Michelle C.

AU - Boohaker, Louis

AU - Eldredge, Laurie C.

AU - Menon, Shina

AU - Griffin, Russell

AU - Mayock, Dennis E.

AU - Li, Linzi

AU - Askenazi, David

AU - Hingorani, Sangeeta

AU - Ambalavanan, Namasivayam

AU - Selewski, David T.

AU - Sarkar, Subrata

AU - Kent, Alison

AU - Fletcher, Jeffery

AU - Abitbol, Carolyn L.

AU - Defreitas, Marissa

AU - Duara, Shahnaz

AU - Charlton, Jennifer R.

AU - Swanson, Jonathan R.

AU - Guillet, Ronnie

AU - D'Angio, Carl

AU - Mian, Ayesa

AU - Rademacher, Erin

AU - Mhanna, Maroun J.

AU - Raina, Rupesh

AU - Kumar, Deepak

AU - Jetton, Jennifer G.

AU - Brophy, Patrick D.

AU - Colaizy, Tarah T.

AU - Klein, Jonathan M.

AU - Arikan, Ayse Akcan

AU - Rhee, Christopher J.

AU - Goldstein, Stuart L.

AU - Nathan, Amy T.

AU - Kupferman, Juan C.

AU - Bhutada, Alok

AU - Rastogi, Shantanu

AU - Bonachea, Elizabeth

AU - Mahan, John

AU - Cole, F. Sessions

AU - Davis, T. Keefe

AU - Dower, Joshua

AU - Milner, Lawrence

AU - Smith, Alexandra

AU - Fuloria, Mamta

AU - Reidy, Kimberly

AU - Kaskel, Frederick J.

AU - Soranno, Danielle E.

AU - Gien, Jason

AU - Gist, Katja M.

AU - Chishti, Aftab S.

AU - Hanna, Mina H.

AU - Wong, Craig S.

AU - Joseph, Catherine

AU - Dupont, Tara

AU - Ohls, Robin

AU - Staples, Amy

AU - Khokhar, Surender

AU - Perazzo, Sofia

AU - Ray, Patricio E.

AU - Revenis, Mary

AU - Sethi, Sidharth K.

AU - Rohatgi, Smriri

AU - Mammen, Cherry

AU - Synnes, Anne

AU - Wazir, Sanjay

AU - Wintermark, Pia

AU - Woroniecki, Robert

AU - Sridhar, Shanty

AU - Ingraham, Susan

AU - Nada, Arwa

AU - Zappitelli, Michael

PY - 2020/2/1

Y1 - 2020/2/1

N2 - Objective This study aimed to evaluate the association between acute kidney injury (AKI) and bronchopulmonary dysplasia (BPD) in infants born <32 weeks of gestational age (GA). Study Design Present study is a secondary analysis of premature infants born at <32 weeks of GA in the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) retrospective cohort (n = 546). We stratified by gestational age and used logistic regression to determine association between AKI and moderate or severe BPD/mortality. Results Moderate or severe BPD occurred in 214 of 546 (39%) infants, while death occurred in 32 of 546 (6%); the composite of moderate or severe BPD/death occurred in 246 of 546 (45%). For infants born ≤29 weeks of gestation, the adjusted odds ratio (OR) of AKI and the primary outcome was 1.15 (95% confidence interval [CI] = 0.47-2.86; p = 0.76). Infants born between 29 and 32 weeks of gestation with AKI had four-fold higher odds of moderate or severe BPD/death that remained after controlling for multiple factors (adjusted OR = 4.21, 95% CI: 2.07-8.61; p < 0.001). Conclusion Neonates born between 29 and 32 weeks who develop AKI had a higher likelihood of moderate or severe BPD/death than those without AKI. Further studies are needed to validate our findings and evaluate mechanisms of multiorgan injury.

AB - Objective This study aimed to evaluate the association between acute kidney injury (AKI) and bronchopulmonary dysplasia (BPD) in infants born <32 weeks of gestational age (GA). Study Design Present study is a secondary analysis of premature infants born at <32 weeks of GA in the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) retrospective cohort (n = 546). We stratified by gestational age and used logistic regression to determine association between AKI and moderate or severe BPD/mortality. Results Moderate or severe BPD occurred in 214 of 546 (39%) infants, while death occurred in 32 of 546 (6%); the composite of moderate or severe BPD/death occurred in 246 of 546 (45%). For infants born ≤29 weeks of gestation, the adjusted odds ratio (OR) of AKI and the primary outcome was 1.15 (95% confidence interval [CI] = 0.47-2.86; p = 0.76). Infants born between 29 and 32 weeks of gestation with AKI had four-fold higher odds of moderate or severe BPD/death that remained after controlling for multiple factors (adjusted OR = 4.21, 95% CI: 2.07-8.61; p < 0.001). Conclusion Neonates born between 29 and 32 weeks who develop AKI had a higher likelihood of moderate or severe BPD/death than those without AKI. Further studies are needed to validate our findings and evaluate mechanisms of multiorgan injury.

KW - acute lung injury

KW - acute renal failure

KW - bronchopulmonary dysplasia

KW - chronic lung disease

KW - neonate

KW - organ crosstalk

KW - prematurity

UR - https://www.scopus.com/pages/publications/85079821127

UR - https://www.scopus.com/pages/publications/85079821127#tab=citedBy

U2 - 10.1055/s-0039-3400311

DO - 10.1055/s-0039-3400311

M3 - Article

C2 - 31777046

AN - SCOPUS:85079821127

SN - 0735-1631

VL - 37

SP - 341

EP - 348

JO - American Journal of Perinatology

JF - American Journal of Perinatology

IS - 3

ER -

Acute Kidney Injury and Bronchopulmonary Dysplasia in Premature Neonates Born Less than 32 Weeks' Gestation

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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