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Relationship of patent ductus arteriosus management with neonatal AKI

Journal of Perinatology volume 41, pages 1441–1447 (2021)Cite this article

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Abstract

Objective

Investigate relationship between management of patent ductus arteriosus (PDA) and acute kidney injury (AKI) in very low birthweight neonates.

Study Design

Retrospective cohort study of neonates, <1500 g, admitted to 24 NICUs, 1/1/14 – 3/31/14. AKI diagnosed using the neonatal modified KDIGO definition; diagnosis and treatment of PDA extracted from the medical record. Demographics, clinical characteristics, and AKI stage compared using chi-square and analysis of variance. A general estimating equation logistic regression used to estimate adjusted odds ratios.

Results

Of 526 neonates with sufficient data to diagnose AKI, 157 (30%) had PDA (61 conservative management, 62 pharmacologic treatment only, 34 surgical ligation). In analyses adjusted for sex, birthweight, gestational age, caffeine, nephrotoxin exposure, vasopressor and mechanical ventilation use, with conservative management as reference, there were no differences among treatment cohorts in the odds of AKI.

Conclusion

The underlying physiology of PDA, not management strategy, may determine the likelihood of AKI in neonates <1500 g.

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Fig. 1: CONSORT diagram of study population.

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Acknowledgements

The authors thank all the members of the Neonatal Kidney Collaborative who participated in the AWAKEN study: University of Alabama, Birmingham: David Askenazi, MD; N. Ambalavanan, MD; Russell Griffin, PhD; Cincinnati Children’s Hospital: Stuart Goldstein, MD; Amy Nathan, MD; James Greenberg, MD; Canberra Hospital: Alison Kent, MD (currently at the University of Rochester); Jeffrey Fletcher, MD; Farah Sethna, MD; Children’s Hospital of Colorado: Danielle Soranno, MD; Jason Gien, MD; Katja Gist, MD; Children’s Hospital at Montefiore/Albert Einstein: Mamta Fuloria, MD; Kim Reidy, MD; Frederick Kastel, MD; Natalie Uy, MD; Children’s National Medical Center: Mary Revenis, MD; Sofia Perrazo, MD; Shantanu Rastogi, MD; Golisano Children’s Hospital University of Rochester: George Schwartz, MD; Carl T. D’Angio, MD; Ronnie Guillet, MD, PhD; Erin Rademacher, MD; Ahmed El Samra, MD (currently Union Hospital, Terre Haute); Ayesa Mian, MD; Maimonides Medical Center: Juan Kupferman, MD; Alok Bhutada, MD; McGill University: Michael Zappitelli, MD; Pia Wintermark, MD; Medanta, Medicity The Cradle: Sanjay Wazir, MD; Sidharth Sethi, MD; Sandeep Dubey, MD; Metrohealth Medical Center: Maroun Mhanna, MD; Deepak Kumar, MD; Rupesh Raina, MD; Nationwide Children’s Hospital: Susan Ingraham, MD; Arwa Nada, MD; Elizabeth Bonachea, MD; Stonybrook University: Richard Fine, MD; Robert Woroniecki, MD; Shanthy Sridhar, MD; Texas Children’s Hospital: Ayse Ariken, MD; Christopher Rhee, MD; Tufts Medical Center: Lawrence Milner, MD; Alexandra Smith, MD; Julie Nicoletta, MD; University of British Columbia: Cherry Mammen, MD; Avash Jeet Singh, MD; Anne Synnes, MD; University of Iowa: Jennifer Jetton, MD; Tarah Colaizy, MD; Jonathan Klein, MD; Patrick Brophy (currently University of Rochester); University of Kentucky: Aftab Chishti, MD; Mina Hanna, MD; University of Miami: Carolyn Abitbol, MD; Marissa Defreitas, MD; Shahnaz Duara, MD; Salih Yasin, MD; University of Michigan: David Selewski, MD (currently Medical University of South Carolina); Subrata Sarker, MD; University of New Mexico: Craig Wong, MD; A. Staples, MD; Robin Ohls, MD; Catherine Joseph, MD (currently Texas Children’s Hospital); Tara Dupont, MD (currently University of Utah); University of Virginia: Jennifer Charlton, MD; Jonathan Swanson, MD; Matthew Harer (currently University of Wisconsin); Patricio Ray, MD; University of Washington: Sangeeta Hingorani, MD; Christine Hu, MD; Sandra Juul, MD.

The Neonatal Kidney Collaborative

David Askenazi5; N. Ambalavanan5; Russell Griffin5; Stuart Goldstein6; Amy Nathan6; James Greenberg6; Alison Kent7; Jeffrey Fletcher7; Farah Sethna7; Danielle Soranno8; Jason Gien8; Katja Gist8; Mamta Fuloria9; Kim Reidy9; Frederick Kastel9; Natalie Uy9; Mary Revenis10; Sofia Perrazo10; Shantanu Rastogi10; George Schwartz11; Carl T. D’Angio11; Ronnie Guillet11; Erin Rademacher11; Ahmed El Samra11,28; Ayesa Mian11; Juan Kupferman12; Alok Bhutada12; Michael Zappitelli13; Pia Wintermark13; Sanjay Wazir14; Sidharth Sethi14; Sandeep Dubey14; Maroun Mhanna15,29; Deepak Kumar15; Rupesh Raina15; Susan Ingraham16; Arwa Nada16; Elizabeth Bonachea16; Richard Fine17; Robert Woroniecki17; Shanthy Sridhar17; Ayse Ariken18; Christopher Rhee18; Lawrence Milner19; Alexandra Smith19; Julie Nicoletta19; Cherry Mammen20; Avash Jeet Singh20; Anne Synnes20; Jennifer Jetton21; Tarah Colaizy21; Jonathan Klein21; Patrick Brophy21,30; Aftab Chishti22; Mina Hanna22; Carolyn Abitbol23; Marissa Defreitas23; Shahnaz Duara23; Salih Yasin23; David Selewski24,31; Subrata Sarker24; Craig Wong25; A. Staples25; Robin Ohls25; Catherine Joseph25,32; Tara Dupont25,33; Jennifer Charlton26; Jonathan Swanson26; Matthew Harer26,34; Patricio Ray26; Sangeeta Hingorani27; Christine Hu27; Sandra Juul27.

Author information

Author notes

  1. Ahmed El Samra

    Present address: Union Hospital, Terre Haute, IN, USA

Authors and Affiliations

  1. Golisano Children’s Hospital, University of Rochester, Rochester, NY, USA

    Ronnie Guillet & Carl T. D’Angio

  2. Medical University of South Carolina, Charleston, SC, USA

    David T. Selewski

  3. University of Alabama, Birmingham, AL, USA

    Russell Griffin & David J. Askenazi

  4. National Children’s Medical Center, George Washington University, Washington, DC, USA

    Shantanu Rastogi

  5. University of Alabama at Birmingham, Birmingham, AL, USA

    David Askenazi, N. Ambalavanan & Russell Griffin

  6. Cincinnati Children’s Hospital, Cincinnati, OH, USA

    Stuart Goldstein, Amy Nathan & James Greenberg

  7. Canberra Hospital, Garran, ACT, Australia

    Alison Kent, Jeffrey Fletcher & Farah Sethna

  8. Children’s Hospital of Colorado, Anschutz, CO, USA

    Danielle Soranno, Jason Gien & Katja Gist

  9. Children’s Hospital at Montefiore/Albert Einstein, Bronx, NY, USA

    Mamta Fuloria, Kim Reidy, Frederick Kastel & Natalie Uy

  10. Children’s National Medical Center, Washington, DC, USA

    Mary Revenis, Sofia Perrazo & Shantanu Rastogi

  11. Golisano Children’s Hospital University of Rochester, Rochester, NY, USA

    George Schwartz, Carl T. D’Angio, Ronnie Guillet, Erin Rademacher, Ahmed El Samra & Ayesa Mian

  12. Maimonides Medical Center, Brooklyn, NY, USA

    Juan Kupferman & Alok Bhutada

  13. McGill University, Montreal, QC, Canada

    Michael Zappitelli & Pia Wintermark

  14. Medanta, Medicity The Cradle, Gurgaon, India

    Sanjay Wazir, Sidharth Sethi & Sandeep Dubey

  15. Metrohealth Medical Center, Cleveland, OH, USA

    Maroun Mhanna, Deepak Kumar & Rupesh Raina

  16. Nationwide Children’s Hospital, Columbus, OH, USA

    Susan Ingraham, Arwa Nada & Elizabeth Bonachea

  17. Stonybrook University, Stonybrook, NY, USA

    Richard Fine, Robert Woroniecki & Shanthy Sridhar

  18. Texas Children’s Hospital, Houston, TX, USA

    Ayse Ariken & Christopher Rhee

  19. Tufts Medical Center, Boston, MA, USA

    Lawrence Milner, Alexandra Smith & Julie Nicoletta

  20. University of British Columbia, Vancouver, BC, Canada

    Cherry Mammen, Avash Jeet Singh & Anne Synnes

  21. University of Iowa, Iowa City, IA, USA

    Jennifer Jetton, Tarah Colaizy, Jonathan Klein & Patrick Brophy

  22. University of Kentucky, Lexington, KY, USA

    Aftab Chishti & Mina Hanna

  23. University of Miami, Miami, FL, USA

    Carolyn Abitbol, Marissa Defreitas, Shahnaz Duara & Salih Yasin

  24. University of Michigan, Ann Arbor, MI, USA

    David Selewski & Subrata Sarker

  25. University of New Mexico, Albuquerque, NM, USA

    Craig Wong, A. Staples, Robin Ohls, Catherine Joseph & Tara Dupont

  26. University of Virginia, Charlottesville, VA, USA

    Jennifer Charlton, Jonathan Swanson, Matthew Harer & Patricio Ray

  27. University of Washington, Seattle, WA, USA

    Sangeeta Hingorani, Christine Hu & Sandra Juul

  28. Louisiana State University, Shreveport, LA, USA

    Maroun Mhanna

  29. University of Rochester, Rochester, NY, USA

    Patrick Brophy

  30. Medical University of South Carolina, Mt Pleasant, SC, USA

    David Selewski

  31. Texas Children’s Hospital, Houston, TX, USA

    Catherine Joseph

  32. University of Utah, Salt Lake City, UT, USA

    Tara Dupont

  33. University of Wisconsin, Madison, WI, USA

    Matthew Harer

Authors
  1. Ronnie Guillet
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  2. David T. Selewski
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  3. Russell Griffin
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  4. Shantanu Rastogi
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  5. David J. Askenazi
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  6. Carl T. D’Angio
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Consortia

on behalf of the Neonatal Kidney Collaborative

  • David Askenazi
  • , N. Ambalavanan
  • , Russell Griffin
  • , Stuart Goldstein
  • , Amy Nathan
  • , James Greenberg
  • , Alison Kent
  • , Jeffrey Fletcher
  • , Farah Sethna
  • , Danielle Soranno
  • , Jason Gien
  • , Katja Gist
  • , Mamta Fuloria
  • , Kim Reidy
  • , Frederick Kastel
  • , Natalie Uy
  • , Mary Revenis
  • , Sofia Perrazo
  • , Shantanu Rastogi
  • , George Schwartz
  • , Carl T. D’Angio
  • , Ronnie Guillet
  • , Erin Rademacher
  • , Ahmed El Samra
  • , Ayesa Mian
  • , Juan Kupferman
  • , Alok Bhutada
  • , Michael Zappitelli
  • , Pia Wintermark
  • , Sanjay Wazir
  • , Sidharth Sethi
  • , Sandeep Dubey
  • , Maroun Mhanna
  • , Deepak Kumar
  • , Rupesh Raina
  • , Susan Ingraham
  • , Arwa Nada
  • , Elizabeth Bonachea
  • , Richard Fine
  • , Robert Woroniecki
  • , Shanthy Sridhar
  • , Ayse Ariken
  • , Christopher Rhee
  • , Lawrence Milner
  • , Alexandra Smith
  • , Julie Nicoletta
  • , Cherry Mammen
  • , Avash Jeet Singh
  • , Anne Synnes
  • , Jennifer Jetton
  • , Tarah Colaizy
  • , Jonathan Klein
  • , Patrick Brophy
  • , Aftab Chishti
  • , Mina Hanna
  • , Carolyn Abitbol
  • , Marissa Defreitas
  • , Shahnaz Duara
  • , Salih Yasin
  • , David Selewski
  • , Subrata Sarker
  • , Craig Wong
  • , A. Staples
  • , Robin Ohls
  • , Catherine Joseph
  • , Tara Dupont
  • , Jennifer Charlton
  • , Jonathan Swanson
  • , Matthew Harer
  • , Patricio Ray
  • , Sangeeta Hingorani
  • , Christine Hu
  •  & Sandra Juul

Contributions

RGu designed the study, acquired data, drafted the manuscript and approved the final version. DS acquired data, contributed to the design of the study, edited the manuscript and approved the final version. RGr performed the statistical analyses, edited the manuscript and approved the final version. SR acquired data, edited the manuscript and approved the final version. DA contributed to the design of the study, edited the manuscript and approved the final version. CD contributed to the design of the study, edited the manuscript and approved the final version.

Corresponding author

Correspondence to Ronnie Guillet.

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Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Members of the Neonatal Kidney Collaborative are listed below Acknowledgements.

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Guillet, R., Selewski, D.T., Griffin, R. et al. Relationship of patent ductus arteriosus management with neonatal AKI. J Perinatol 41, 1441–1447 (2021). https://doi.org/10.1038/s41372-021-01054-1

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