Todo Bom Costa Sara, Costa Reis Patrícia, Mendes Graça André
Neonatology Service, Pediatrics Department, Hospital Santa Maria, Unidade Local de Saúde Santa Maria, Lisbon, Portugal.
Hospital CUF Descobertas, Lisbon, Portugal.
J Perinatol. 2025 Aug 4. doi: 10.1038/s41372-025-02379-x.
To assess risk factors for acute kidney injury (AKI) in neonates with hypoxic ischemic encephalopathy (HIE) using KDIGO and Gupta definitions, and evaluate long-term kidney function.
Retrospective study including 72 neonates with HIE and prospective evaluation of long-term kidney health data of 33 survivors.
AKI was detected in 49% using KDIGO and 32% using Gupta's definition. KDIGO-defined AKI correlated with thrombocytopenia, low pH, transfusions need, nephrotoxic drugs, and furosemide use (p < 0.05). The Gupta definition showed additional associations with hypotension, cardiac dysfunction, and death (p < 0.05). In a logistic regression model, both definitions linked AKI to nephrotoxic drug exposure and transfusions. Follow-up assessments revealed elevated blood pressure in 12%, hyperfiltration in 18%, and proteinuria in 6% of survivors.
The Gupta definition may help identify AKI in an additional number of neonates with HIE. Long-term monitoring is essential for the early detection of kidney dysfunction.
使用KDIGO和古普塔（Gupta）的定义评估缺氧缺血性脑病（HIE）新生儿急性肾损伤（AKI）的危险因素，并评估长期肾功能。
回顾性研究纳入72例HIE新生儿，并对33例幸存者的长期肾脏健康数据进行前瞻性评估。
使用KDIGO定义检测到49%的患儿发生AKI，使用古普塔定义检测到32%。KDIGO定义的AKI与血小板减少、低pH值、输血需求、肾毒性药物和呋塞米使用相关（p<0.05）。古普塔定义还显示与低血压、心脏功能障碍和死亡相关（p<0.05）。在逻辑回归模型中，两种定义均将AKI与肾毒性药物暴露和输血联系起来。随访评估显示，12%的幸存者血压升高，18%的幸存者出现超滤，6%的幸存者出现蛋白尿。
古普塔定义可能有助于识别更多HIE新生儿中的AKI。长期监测对于早期发现肾功能障碍至关重要。
