Abstract
Objective: To investigate whether NICU discharge summaries documented neonatal AKI and estimate if nephrology consultation mediated this association. Study design: Secondary analysis of AWAKEN multicenter retrospective cohort. Exposures: AKI severity and diagnostic criteria. Outcome: AKI documentation on NICU discharge summaries using multivariable logistic regression to estimate associations and test for causal mediation. Results: Among 605 neonates with AKI, 13% had documented AKI. Those with documented AKI were more likely to have severe AKI (70.5% vs. 51%, p < 0.001) and SCr-only AKI (76.9% vs. 50.1%, p = 0.04). Nephrology consultation mediated 78.0% (95% CL 46.5–109.4%) of the total effect of AKI severity and 82.8% (95% CL 70.3–95.3%) of the total effect of AKI diagnostic criteria on documentation. Conclusion: We report a low prevalence of AKI documentation at NICU discharge. AKI severity and SCr-only AKI increased odds of AKI documentation. Nephrology consultation mediated the associations of AKI severity and diagnostic criteria with documentation.
| Original language | English |
|---|---|
| Pages (from-to) | 930-936 |
| Number of pages | 7 |
| Journal | Journal of Perinatology |
| Volume | 42 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2022 |
Bibliographical note
Publisher Copyright:© 2022, The Author(s), under exclusive licence to Springer Nature America, Inc.
Funding
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 2 of the AWAKEN study investigators at UAB (D.A. and R.G.). 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. 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. For full disclosure, we provide the additional list of authors’ other funding not directly related to this study. DA consults for and received research/education grants with Baxter, Medtronic, Nuwellis, Bioporto and Seastar. He has patent pending inventions in the area of neonatal nephrology. AS reports receiving grant funding for studies not related to this work, grants NHLBI K23 HL148394, L40 HL148910, and R01 HL146818. MS is supported in part by the Indiana University School of Medicine Physician Scientist Initiative. No other disclosures were reported.
| Funders | Funder number |
|---|---|
| University of Alabama, Birmingham | |
| 100 Women Charitable Foundation | |
| Children's of Alabama | |
| Indiana University School of Medicine | |
| National Institutes of Health (NIH) | |
| Center for Clinical and Translational Science, University of Alabama at Birmingham | |
| National Heart, Lung, and Blood Institute (NHLBI) | R01HL146818, K23HL148394, L40HL148910 |
| National Center for Advancing Translational Sciences (NCATS) | U54TR001356, UL1TR001417, UL1TR001449 |
| New Mexico State University, New York University | UL1TR001449 |
| Indiana Clinical and Translational Sciences Institute | U54TR001356 |
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Obstetrics and Gynecology
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