The spectrum of onset of acute kidney injury in premature infants less than 30 weeks gestation

OBJECTIVE: To determine risk factors for acute kidney injury (AKI) in preterm infants as a function of time of onset. STUDY DESIGN: In this 5 1/2-year, single-center, retrospective study, incidence and timing of AKI was determined using modified Acute Kidney Injury Network criteria. Characteristics of newborns with and without AKI were compared by chi square and t-tests. Logistic regression was used to examine risk factors for AKI as a function of time of onset and potential confounders. RESULT: AKI occurred in 30.3% of 357 neonates; 72.2% was stage 1. Gestational ages (GA), initial Cr, maternal magnesium and volume resuscitation were associated with early AKI (days 0 to 1). Volume resuscitation, umbilical arterial line and receipt of non-steroidal anti-inflammatory drug (NSAID) for patent ductus arteriosus were associated with intermediate AKI (days 2 to 5). GA, steroids for early hypotension, necrotizing enterocolitis and sepsis were associated with late AKI (. day 6). CONCLUSION: Stage 1 AKI is a common morbidity in our population. Risk factors for AKI in our population differed with time of onset.