Necrotising enterocolitis Significantly Increases Risk of Acute Kidney Injury in Preterm Infants, reveals research
Researchers have found in a new study that necrotising enterocolitis (NEC) particularly raises the preterm infant's risk of developing acute kidney injury (AKI) considerably, and hence there is a need for monitoring kidney function in early stages among this at-risk group. NEC is among the most critical gastrointestinal emergencies in neonates and is still one of the top causes of morbidity and mortality among premature infants. The study was published in the European Journal of Pediatrics by Dermot W. and colleagues.
The study was done as a retrospective 1:2 case–control study in a tertiary NICU from October 2018 to October 2023. The study involved 149 preterm infants, of which 49 were diagnosed with NEC and 100 were matched controls. The matching was done according to birth weight, gestational age, and gender to reduce confounding variables. AKI was determined according to modified neonatal KDIGO criteria, taking into account both urine output and serum creatinine levels to provide diagnostic accuracy.
Results
Total infants: 149 (49 NEC, 100 controls)
Overall AKI incidence: 16.8% (25 infants)
AKI in NEC group: 30.6%
AKI in control group: 10%
Adjusted odds ratio for AKI with NEC: 3.6 (95% CI 1.3–10.2, p = 0.0129)
Median time to AKI onset: 2 days after NEC diagnosis
Mortality in NEC with AKI: 60%
Mortality in NEC without AKI: 20.6%
Association between Bell stage and AKI: Not significant
The present study presents strong evidence that necrotising enterocolitis increases significantly the risk of acute kidney injury among preterm infants, regardless of birth weight, gestational age, or drug use. As AKI occurrence almost tripled in NEC patients and related mortality up to 60%, the inclusion of early kidney surveillance in NEC management protocols is warranted.
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