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Association of early dysnatremia with mortality in the neonatal intensive care unit: results from the AWAKEN study

Producción científica: Article › revisión exhaustiva

11 Citas (Scopus)

Resumen

Objective: To determine the association of dysnatremia in the first postnatal week and risk of acute kidney injury (AKI) and mortality. Study design: A secondary analysis of 1979 neonates in the AWAKEN cohort evaluated the association of dysnatremia with (1) AKI in the first postnatal week and (2) mortality, utilizing time-varying Cox proportional hazard models. Result: Dysnatremia developed in 50.2% of the cohort and was not associated with AKI. Mortality was associated with hyponatremia (HR 2.15, 95% CI 1.07–4.31), hypernatremia (HR 4.23, 95% CI 2.07–8.65), and combined hypo/hypernatremia (HR 6.39, 95% CI 2.01–14.01). In stratified models by AKI-status, hypernatremia and hypo/hypernatremia increased risk of mortality in neonates without AKI. Conclusion: Dysnatremia within the first postnatal week was associated with increased risk of mortality. Hypernatremia and combined hypo/hypernatremia remained significantly associated with mortality in neonates without AKI. This may reflect fluid strategies kidney injury independent of creatinine and urine-output defined AKI, and/or systemic inflammation.

Idioma originalEnglish
Páginas (desde-hasta)1353-1360
Número de páginas8
PublicaciónJournal of Perinatology
Volumen42
N.º10
DOI
EstadoPublished - oct 2022

Nota bibliográfica

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.

Financiación

The authors thank all the members of the Neonatal Kidney Collaborative who participated in the AWAKEN study: University of Alabama, Birmingham: David Askenazi, MD; Namasivayam Ambalavanan, MD; Russell Griffin, PhD; Cincinnati Children’s Hospital: Stuart Goldstein, MD; Amy Nathan, MD; James Greenberg, MD; Canberra Hospital: Alison Kent, MD (currently at the University of Rochester); Jeffrey Fletcher, MD; Farah Sethna, MD; Children’s Hospital of Colorado: Danielle Soranno, MD; Jason Gien, MD; Katja Gist, MD; Children’s Hospital at Montefiore/Albert Einstein: Mamta Fuloria, MD; Kim Reidy, MD; Frederick Kaskel, MD; Natalie Uy, MD; Children’s National Medical Center: Mary Revenis, MD; Sofia Perrazo, MD; Shantanu Rastogi, MD; Golisano Children’s Hospital University of Rochester: George Schwartz, MD; Carl T. D’Angio, MD; Ronnie Guillet, MD, PhD; Erin Rademacher, MD; Ahmed El Samra, MD (currently Union Hospital, Terre Haute); Ayesa Mian, MD; Maimonides Medical Center: Juan Kupferman, MD; Alok Bhutada, MD; McGill University: Michael Zappitelli, MD; Pia Wintermark, MD; Medanta, Medicity The Cradle: Sanjay Wazir, MD; Sidharth Sethi, MD; Sandeep Dubey, MD; Metrohealth Medical Center: Maroun Mhanna, MD; Deepak Kumar, MD; Rupesh Raina, MD; Nationwide Children’s Hospital: Susan Ingraham, MD; Arwa Nada, MD; Elizabeth Bonachea, MD; Stonybrook University: Richard Fine, MD; Robert Woroniecki, MD; Shanthy Sridhar, MD; Texas Children’s Hospital: Ayse Ariken, MD; Christopher Rhee, MD; Tufts Medical Center: Lawrence Milner, MD; Alexandra Smith, MD; Julie Nicoletta, MD; University of British Columbia: Cherry Mammen, MD; Avash Jeet Singh, MD; Anne Synnes, MD; University of Iowa: Jennifer Jetton, MD; Tarah Colaizy, MD; Jonathan Klein, MD; Patrick Brophy (currently University of Rochester); University of Kentucky: Aftab Chishti, MD; Mina Hanna, MD; University of Miami: Carolyn Abitbol, MD; Marissa Defreitas, MD; Shahnaz Duara, MD; Salih Yasin, MD; University of Michigan: David Selewski, MD (currently Medical University of South Carolina); Subrata Sarker, MD; University of New Mexico: Craig Wong, MD; A. Staples, MD; Robin Ohls, MD; Catherine Joseph, MD (currently Texas Children’s Hospital); Tara Dupont, MD (currently University of Utah); University of Virginia: Jennifer Charlton, MD; Jonathan R. Swanson, MD; Matthew Harer (currently University of Wisconsin); Patricio Ray, MD; University of Washington: Sangeeta Hingorani, MD; Christine Hu, MD; Sandra Juul, MD. This study was supported by the NIH T32 NIDDK 5T32DK007110- 46 and NIH/NCATS Einstein-Montefiore CTSA Grant UL1TR002556. 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). 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). 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.

FinanciadoresNúmero del financiador
University of Alabama
Stonybrook University
Children's of Alabama
100 Women Charitable Foundation
University of Kentucky
University of Utah
Universitat Autònoma de Barcelona
Miami Clinical and Translational Science Institute, University of Miami
Virginia Agricultural Experiment Station, Virginia Polytechnic Institute and State University
Center for Clinical and Translational Science, University of Alabama at Birmingham
Cincinnati Children's Hospital Medical Center
The George Washington University
Michigan Diabetes Research Center, University of Michigan
New Mexico State University, New York UniversityUL1TR001449
University of Iowa Institute for Clinical and Translational ScienceU54TR001356
National Institutes of Health, National Institutes of HealthUL1TR001417, T32 NIDDK 5T32DK007110- 46
National Center for Advancing Translational Sciences (NCATS)UL1TR002556

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Obstetrics and Gynecology

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