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Improving the identification of acute kidney injury in the neonatal ICU: three centers’ experiences

Journal of Perinatology volume 42, pages 243–246 (2022)Cite this article

Subjects

Abstract

Objective

To describe three different standardized approaches to improving neonatal acute kidney injury (AKI) identification and the impact on AKI identification, incidence, and nephrology consultation and referral.

Study design

A retrospective cohort study in three academic NICUs. We compared AKI identification, AKI incidence, nephrology consultation, and nephrology follow-up before and after implantation of local protocols to standardize neonatal AKI identification.

Result

Neonatal AKI identification improved in all three NICUs following protocol implementation (26–85%, P < 0.0001). Each center also saw increases in nephrology consultation (15–83%, P < 0.0001) and nephrology follow-up (7–73%, P < 0.0001). AKI incidence decreased significantly (21–12%, P < 0.0001).

Conclusion

Multiple strategies can be successfully operationalized to improve neonatal AKI identification. While different in approach, each strategy resulted in increased AKI identification and nephrology involvement. This study emphasizes the importance of local standardized approaches to AKI to improve AKI identification and nephrology involvement in the NICU.

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Acknowledgements

The authors would like to thank Samantha Wallace (Department of Pediatrics, Indiana University School of Medicine) for help with technical editing and proofreading of the manuscript. We would also like to thank Drs. Tricia Dias, Cara Slagle, Lauren Das, and Dorota Marchel (MUSC) for their assistance with data collection.

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Authors and Affiliations

  1. Riley Hospital for Children and Indiana University School of Medicine, Indianapolis, IN, USA

    Michelle C. Starr, Paulomi Chaudhry & Allyson Brock

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

    Katherine Vincent & Katherine Twombley

  3. Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, OH, USA

    Elizabeth M. Bonachea & Tahagod H. Mohamed

Authors
  1. Michelle C. Starr
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  2. Paulomi Chaudhry
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  3. Allyson Brock
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  4. Katherine Vincent
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  5. Katherine Twombley
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  6. Elizabeth M. Bonachea
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  7. Tahagod H. Mohamed
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Contributions

MS conceptualized and designed the study, collected data, carried out the analysis, drafted the initial manuscript, and reviewed and revised the manuscript. TM and KT conceptualized and designed the study, collected data, and reviewed and revised the manuscript. PC, AB, KV, and EB assisted with the design of the study and reviewed and revised the manuscript for important intellectual content. All authors approve the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Michelle C. Starr.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The Institutional Review Board at Indiana University School of Medicine and Medical University of South Carolina reviewed and approved this project as expedited human subjects research. The Nationwide Children’s Hospital Institutional Review Board reviewed the project and found it exempt.

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Starr, M.C., Chaudhry, P., Brock, A. et al. Improving the identification of acute kidney injury in the neonatal ICU: three centers’ experiences. J Perinatol 42, 243–246 (2022). https://doi.org/10.1038/s41372-021-01198-0

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