King Jeffrey E, Newman Jill C, Kinsinger Olivia, Mead Molly, Rodgers Megan D, Ruddy-Humphries Amy L, Coleman Cassandra, Selewski David T, Steflik Heidi J
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
Department of Pediatrics, Vanderbilt University, Nashville, TN, USA.
J Perinatol. 2025 Jul 25. doi: 10.1038/s41372-025-02370-6.
Associations between neonatal acute kidney injury (AKI) and neurodevelopmental impairment (NDI) remains understudied. We hypothesized AKI is associated with NDI in very low birthweight (VLBW) infants.
A single-center, retrospective cohort study of VLBW infants with and without AKI during hospitalization evaluated in developmental clinic at 18 to 35 months of age. Associations between AKI and NDI were examined using bivariate and multivariable generalized linear mixed modeling.
Of 203 infants included, 64 (32%) experienced neonatal AKI and 76 (37%) developed NDI. The relative risk of NDI was significantly higher in those with AKI (RR 1.67, 95% CI 1.18-2.36; p < 0.01). In multivariable analysis, AKI was not an independent predictor of NDI (aRR 1.07, 95% CI 0.68-1.68; p = 0.77).
In bivariate analyses, AKI was a significant predictor of NDI. In a multivariable model, AKI was no longer an independent predictor of NDI. Further investigation is warranted.
新生儿急性肾损伤（AKI）与神经发育障碍（NDI）之间的关联仍未得到充分研究。我们假设AKI与极低出生体重（VLBW）婴儿的NDI有关。
一项单中心回顾性队列研究，对住院期间患有和未患有AKI的VLBW婴儿在18至35个月龄时进行发育门诊评估。使用双变量和多变量广义线性混合模型检查AKI与NDI之间的关联。
在纳入的203名婴儿中，64名（32%）经历了新生儿AKI，76名（37%）出现了NDI。患有AKI的婴儿发生NDI的相对风险显著更高（RR 1.67，95%CI 1.18 - 2.36；p < 0.01）。在多变量分析中，AKI不是NDI的独立预测因素（校正风险比1.07，95%CI 0.68 - 1.68；p = 0.77）。
在双变量分析中，AKI是NDI的显著预测因素。在多变量模型中，AKI不再是NDI的独立预测因素。有必要进行进一步调查。
