Ling Li, Hui-Ling Shu, Shu-Dong Cui, Xiao-Lin Miao, Xiao-Qing Chen, Jing-Jing Pan, Yang Yang
{"title":"极低胎龄新生儿（elgan）急性肾损伤的危险因素——一项回顾性病例对照研究","authors":"Ling Li, Hui-Ling Shu, Shu-Dong Cui, Xiao-Lin Miao, Xiao-Qing Chen, Jing-Jing Pan, Yang Yang","doi":"10.1007/s00467-025-06809-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Neonatal acute kidney injury (AKI) is associated with poor clinical outcomes. Consequently, this study was designed to explore the prenatal and postnatal risk factors in Chinese extremely low gestational age neonates (ELGANs).</p><p><strong>Methods: </strong>This retrospective study included all ELGANs (born between 23-0/7 and 27-6/7 weeks of gestation) hospitalized from January 2019 to December 2022. These premature babies were divided into the AKI group (n = 39) and the non-AKI group (n = 76) according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria.</p><p><strong>Results: </strong>AKI most frequently occurred in the first 10 days of life (median: 8th day, quartile range: 6th - 10th day). Most infants (61.54%) manifested stage 1 AKI. Lower gestational age (GA) was the major independent risk factor for AKI [adjusted OR (aOR): 0.40, 95% CI: 0.22-0.67]. Moreover, the lower the GA, the higher the risk of AKI. When the interactive effect between GA and nonsteroidal anti-inflammatory drugs (NSAIDs) was considered, NSAIDs administration would greatly enhance the risk of AKI (interaction term, aOR: 3.94, 95% CI: 1.26-13.92). The levels of serum creatinine and urea nitrogen in the AKI group generally returned to normal upon discharge and continued until 6 months after follow-up.</p><p><strong>Conclusion: </strong>When using NSAIDs in the ELGANs population, great attention should be paid to dynamically monitor kidney function.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":"2981-2991"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk factors of acute kidney injury in extremely low gestational age neonates (ELGANs) - a retrospective case-control study.\",\"authors\":\"Ling Li, Hui-Ling Shu, Shu-Dong Cui, Xiao-Lin Miao, Xiao-Qing Chen, Jing-Jing Pan, Yang Yang\",\"doi\":\"10.1007/s00467-025-06809-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Neonatal acute kidney injury (AKI) is associated with poor clinical outcomes. Consequently, this study was designed to explore the prenatal and postnatal risk factors in Chinese extremely low gestational age neonates (ELGANs).</p><p><strong>Methods: </strong>This retrospective study included all ELGANs (born between 23-0/7 and 27-6/7 weeks of gestation) hospitalized from January 2019 to December 2022. These premature babies were divided into the AKI group (n = 39) and the non-AKI group (n = 76) according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria.</p><p><strong>Results: </strong>AKI most frequently occurred in the first 10 days of life (median: 8th day, quartile range: 6th - 10th day). Most infants (61.54%) manifested stage 1 AKI. Lower gestational age (GA) was the major independent risk factor for AKI [adjusted OR (aOR): 0.40, 95% CI: 0.22-0.67]. Moreover, the lower the GA, the higher the risk of AKI. When the interactive effect between GA and nonsteroidal anti-inflammatory drugs (NSAIDs) was considered, NSAIDs administration would greatly enhance the risk of AKI (interaction term, aOR: 3.94, 95% CI: 1.26-13.92). The levels of serum creatinine and urea nitrogen in the AKI group generally returned to normal upon discharge and continued until 6 months after follow-up.</p><p><strong>Conclusion: </strong>When using NSAIDs in the ELGANs population, great attention should be paid to dynamically monitor kidney function.</p>\",\"PeriodicalId\":19735,\"journal\":{\"name\":\"Pediatric Nephrology\",\"volume\":\" \",\"pages\":\"2981-2991\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00467-025-06809-y\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00467-025-06809-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/22 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Risk factors of acute kidney injury in extremely low gestational age neonates (ELGANs) - a retrospective case-control study.
Background: Neonatal acute kidney injury (AKI) is associated with poor clinical outcomes. Consequently, this study was designed to explore the prenatal and postnatal risk factors in Chinese extremely low gestational age neonates (ELGANs).
Methods: This retrospective study included all ELGANs (born between 23-0/7 and 27-6/7 weeks of gestation) hospitalized from January 2019 to December 2022. These premature babies were divided into the AKI group (n = 39) and the non-AKI group (n = 76) according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria.
Results: AKI most frequently occurred in the first 10 days of life (median: 8th day, quartile range: 6th - 10th day). Most infants (61.54%) manifested stage 1 AKI. Lower gestational age (GA) was the major independent risk factor for AKI [adjusted OR (aOR): 0.40, 95% CI: 0.22-0.67]. Moreover, the lower the GA, the higher the risk of AKI. When the interactive effect between GA and nonsteroidal anti-inflammatory drugs (NSAIDs) was considered, NSAIDs administration would greatly enhance the risk of AKI (interaction term, aOR: 3.94, 95% CI: 1.26-13.92). The levels of serum creatinine and urea nitrogen in the AKI group generally returned to normal upon discharge and continued until 6 months after follow-up.
Conclusion: When using NSAIDs in the ELGANs population, great attention should be paid to dynamically monitor kidney function.
期刊介绍：
International Pediatric Nephrology Association
Pediatric Nephrology publishes original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies may involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. There are 12 issues per year that contain Editorial Commentaries, Reviews, Educational Reviews, Original Articles, Brief Reports, Rapid Communications, Clinical Quizzes, and Letters to the Editors.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
