title: Outcome of extremely low birth weight infants with a history of neonatal acute kidney injury.
abstract: To study the outcome of extremely low birth weight (ELBW) infants with a history of acute kidney injury (AKI).
  
  
  
  In a retrospective, case control study, medical records of all ELBW infants admitted to the neonatal intensive care unit (NICU) between Jan 2002 and Dec 2011 were reviewed. Medical records were reviewed for infants' demographics, blood pressure (BP) at NICU discharge and at ≥3 years, and estimated glomerular filtration rate (eGFR) at ≥2 years.
  
  
  
  During the study period, 222 patients met the inclusion criteria, of whom 10% (23 out of 222) had AKI stage 2 and 3, 39% (87 out of 222) had AKI stage 1, and the rest did not have AKI. At NICU discharge, there was a difference in diastolic BP (DBP) among infants who had AKI stages 2 and 3, those who had stage 1, and those who did not have AKI (53 ± 12 vs 46 ± 9 vs 46 ± 11 mmHg respectively; p = 0.007), and 11% (23 out of 209) had hypertension (HTN). Although there was a significant correlation between the rise in SCr and DBP at NICU discharge in infants with AKI (R = 0.304; p = 0.004), there was no difference in HTN between infants with and those without AKI. At ≥2 years of age, 4% (5 out of 120) across all groups had an eGFR < 90 ml/min/1.73m2or chronic kidney disease (CKD). At ≥3 years of age, 5% (11 out of 222) had HTN.
  
  
  
  At NICU discharge, infants with AKI stages 2 and 3 have a higher DBP than infants with stage 1 AKI and those who did not have AKI. However, there is no difference in the rate of HTN between the two groups. At ≥2 years ELBW infants are at risk for CKD independently of whether or not they develop neonatal AKI.
authors.affiliation: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
authors.forename: Syeda
authors.initials: S
authors.lastname: Maqsood
authors.affiliation: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Fung
authors.affiliation: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
authors.forename: Vikas
authors.initials: V
authors.lastname: Chowdhary
authors.affiliation: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Raina
authors.affiliation: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA. mmhanna@metrohealth.org.
authors.forename: Maroun J
authors.initials: MJ
authors.lastname: Mhanna
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D000367:Age Factors; D001795:Blood Pressure Determination; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D003404:Creatinine
keywords: Acute kidney injury; Blood pressure; Extremely low birth weight; Serum creatinine