دورية أكاديمية

Renal oximetry for early acute kidney injury detection in neonates with hypoxic ischemic encephalopathy receiving therapeutic hypothermia.

التفاصيل البيبلوغرافية
العنوان: Renal oximetry for early acute kidney injury detection in neonates with hypoxic ischemic encephalopathy receiving therapeutic hypothermia.
المؤلفون: Rumpel JA; Division of Neonatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA. Jarumpel@uams.edu.; Arkansas Children's Hospital, One Children's Way Slot 512-5, Little Rock, AR, 72205, USA. Jarumpel@uams.edu., Spray BJ; Arkansas Children's Research Institute, Little Rock, AR, USA., Frymoyer A; Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA., Rogers S; Division of Neonatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Cho SH; Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA., Ranabothu S; Division of Nephrology, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Blaszak R; Division of Nephrology, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Courtney SE; Division of Neonatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Chock VY; Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
المصدر: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2023 Aug; Vol. 38 (8), pp. 2839-2849. Date of Electronic Publication: 2023 Feb 14.
نوع المنشور: Observational Study; Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8708728 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-198X (Electronic) Linking ISSN: 0931041X NLM ISO Abbreviation: Pediatr Nephrol Subsets: MEDLINE
أسماء مطبوعة: Publication: Berlin : Springer International
Original Publication: Berlin : Springer International, c1987-
مواضيع طبية MeSH: Hypoxia-Ischemia, Brain*/complications , Hypoxia-Ischemia, Brain*/diagnosis , Hypoxia-Ischemia, Brain*/therapy , Acute Kidney Injury*/diagnosis , Acute Kidney Injury*/etiology , Acute Kidney Injury*/therapy , Hypothermia, Induced*/adverse effects , Hypothermia, Induced*/methods, Infant, Newborn ; Infant ; Female ; Pregnancy ; Humans ; Kidney ; Oximetry
مستخلص: Background: Neonates with hypoxic ischemic encephalopathy (HIE) receiving therapeutic hypothermia are at high risk of acute kidney injury (AKI).
Methods: We performed a two-site prospective observational study from 2018 to 2019 to evaluate the utility of renal near-infrared spectroscopy (NIRS) in detecting AKI in 38 neonates with HIE receiving therapeutic hypothermia. AKI was defined by a delayed rate of serum creatinine decline (< 33% on day 3 of life, < 40% on day 5, and < 46% on day 7). Renal saturation (R sat ) and systemic oxygen saturation (SpO2) were continuously measured for the first 96 h of life (HOL). Renal fractional tissue oxygen extraction (RFTOE) was calculated as (SpO2 - R sat )/(SpO2). Using renal NIRS, urine biomarkers, and perinatal factors, logistic regression was performed to develop a model that predicted AKI.
Results: AKI occurred in 20 of 38 neonates (53%). During the first 96 HOL, R sat was higher, and RFTOE was lower in the AKI group vs. the no AKI group (P < 0.001). R sat  > 70% had a fair predictive performance for AKI at 48-84 HOL (AUC 0.71-0.79). RFTOE ≤ 25 had a good predictive performance for AKI at 42-66 HOL (AUC 0.8-0.83). The final statistical model with the best fit to predict AKI (AUC = 0.88) included RFTOE at 48 HOL (P = 0.012) and pH of the infants' first postnatal blood gas (P = 0.025).
Conclusions: Lower RFTOE on renal NIRS and pH on infant first blood gas may be early predictors for AKI in neonates with HIE receiving therapeutic hypothermia. A higher resolution version of the Graphical abstract is available as Supplementary information.
(© 2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
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فهرسة مساهمة: Keywords: Acute kidney injury; Hypoxic ischemic encephalopathy; Near-infrared spectroscopy; Neonates; Renal fractional tissue oxygen extraction; Therapeutic hypothermia
تواريخ الأحداث: Date Created: 20230214 Date Completed: 20231023 Latest Revision: 20231026
رمز التحديث: 20240628
DOI: 10.1007/s00467-023-05892-3
PMID: 36786860
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-198X
DOI:10.1007/s00467-023-05892-3