title: Caffeine Exposure and Risk of Acute Kidney Injury in a Retrospective Cohort of Very Low Birth Weight Neonates.
abstract: To evaluate the association between caffeine exposure and acute kidney injury (AKI) in very low birth weight (VLBW; ≤1500 g) neonates.
  
  
  
  We retrospectively reviewed a cohort of 140 VLBW neonates consecutively admitted to the University of Virginia's neonatal intensive care unit from March 2011 to June 2012, excluding only those admitted >2 days of age or who died at <2 days after birth. We separately analyzed a subgroup of 44 neonates who received prolonged invasive respiratory support (mechanical ventilation for first 7 days after birth). The exposure of interest was caffeine exposure in the first week after birth. The primary outcome was AKI within the first 10 days after birth according to the Kidney Disease: Improving Global Outcomes system, modified to include only serum creatinine.
  
  
  
  Caffeine exposure occurred in 72.1% of all patients and 54.5% of those who received prolonged invasive respiratory support. AKI occurred less frequently in neonates who received caffeine (all patients: 17.8% vs 43.6%; P = .002; prolonged invasive respiratory support: 29.2% vs 75.0%; P = .002). Caffeine exposure was associated with decreased odds for AKI in logistic regression models adjusted for sex, birth weight, gestational age, small for gestational age status, illness severity on admission, and receipt of indomethacin, invasive ventilation, dopamine, aminoglycosides, and vancomycin (all patients: OR 0.22; 95% CI 0.07-0.75, P = .02; prolonged invasive respiratory support subgroup: OR 0.06; 95% CI 0.01-0.57, P = .02).
  
  
  
  In a cohort of VLBW neonates, those exposed to caffeine were less likely to experience AKI.
authors.affiliation: Division of Nephrology, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA.
authors.forename: J Bryan
authors.initials: JB
authors.lastname: Carmody
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, VA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Harer
authors.affiliation: Department of Pediatrics, Ospedale Regionale per le Microcitemie, University of Cagliari, Cagliari, Italy.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Denotti
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, VA.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Swanson
authors.affiliation: Division of Nephrology, Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, VA. Electronic address: jrc6n@virginia.edu.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Charlton
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002110:Caffeine / Q000008:administration & dosage*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D002110:Caffeine; D003404:Creatinine