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Describing patterns in serum creatinine in infants with and without necrotizing enterocolitis

Journal of Perinatology volume 43, pages 86–90 (2023)Cite this article

Subjects

Abstract

Objective

To evaluate serum creatinine (SCr) patterns and the development of acute kidney injury (AKI), as potential biomarkers of necrotizing enterocolitis (NEC).

Study design

Retrospective chart review of preterm infants with and without NEC born 23–32 weeks gestation admitted to Nationwide Children’s Hospital NICU. Medical versus surgical NEC was determined by radiographic and clinical findings. Available inpatient SCr levels obtained on days 8 through 365 were included.

Result

In this cohort, 77 NEC and a randomly selected group of 82 non-NEC infants met inclusion criteria. Fifteen of the 70 (21.4%) with NEC met criteria for AKI versus 0 of 43 (0.0%) without NEC. One of the 13 with AKI had AKI within 7 days prior to NEC diagnosis (7.7%).

Conclusion

AKI is more prevalent in infants with NEC. The temporal association between AKI and NEC could not be evaluated due to inconsistent SCr surveillance and should be evaluated in future studies.

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Fig. 1: Flow diagram of patients with and without NEC.
Fig. 2: Serum creatinine values.
Fig. 3: Interval days in between serum creatinine level checks in patients with and without NEC.

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Data availability

The data that support the findings of this study are available within the article and are also available from the corresponding author, RH, upon reasonable request.

References

  1. Garg PM, Britt AB, Ansari MAY, Sobisek S, Block DK, Paschal JL, et al. Severe acute kidney injury in neonates with necrotizing enterocolitis: risk factors and outcomes. Pediatr Res. 2021;90:642–9.

    Article  Google Scholar 

  2. Criss CN, Selewski DT, Sunkara B, Gish JS, Hsieh L, McLeod JS, et al. Acute kidney injury in necrotizing enterocolitis predicts mortality. Pediatr Nephrol. 2018;33:503–10.

    Article  Google Scholar 

  3. Neu J, Walker WA. Necrotizing enterocolitis. N. Engl J Med. 2011;364:255–64.

    Article  CAS  Google Scholar 

  4. Meister AL, Doheny KK, Travagli RA. Necrotizing enterocolitis: It’s not all in the gut. 2020;245:85–95.

  5. Ward RM, Beachy JC. Neonatal complications following preterm birth. BJOG: Int J Obstet Gynaecol. 2003;110:8–16.

    Article  Google Scholar 

  6. Yee WH, Soraisham AS, Shah VS, Aziz K, Yoon W, Lee SK. Incidence and timing of presentation of necrotizing enterocolitis in preterm infants. Pediatrics 2012;129:e298–304.

    Article  Google Scholar 

  7. Ng PC. Biomarkers of necrotising enterocolitis. Semin Fetal Neonatal Med. 2014;19:33–8.

    Article  Google Scholar 

  8. Askenazi DJ, Ambalavanan N, Goldstein SL. Acute kidney injury in critically ill newborns: what do we know? What do we need to learn? Pediatr Nephrol. 2009;24:265–74.

    Article  Google Scholar 

  9. Jetton JG, Askenazi DJ. Update on acute kidney injury in the neonate. Curr Opin Pediatr. 2012;24:191–6.

    Article  CAS  Google Scholar 

  10. Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE, et al. Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study. Lancet Child Adolesc Health. 2017;1:184–94.

    Article  Google Scholar 

  11. El-Badawy AA, Makar S, Abdel-Razek AR, Abd, Elaziz D. Incidence and risk factors of acute kidney injury among the critically ill neonates. Saudi J Kidney Dis Transpl: Off Publ Saudi Cent Organ Transpl Saudi Arabia 2015;26:549–55.

    Article  Google Scholar 

  12. Zappitelli M, Ambalavanan N, Askenazi DJ, Moxey-Mims MM, Kimmel PL, Star RA, et al. Developing a neonatal acute kidney injury research definition: a report from the NIDDK neonatal AKI workshop. Pediatr Res. 2017;82:569–73.

    Article  Google Scholar 

  13. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453–7.

    Article  Google Scholar 

  14. Roy JP, Goldstein SL, Schuh MP. Under-recognition of neonatal acute kidney injury and lack of follow-up. Am J Perinatol. 2022;39:526–31.

    Article  Google Scholar 

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Acknowledgements

This research was supported by the Ohio Perinatal Research Network of Nationwide Children’s Hospital.

Author information

Authors and Affiliations

  1. Division of Neonatology, Nationwide Children’s Hospital, Columbus, OH, USA

    Rachel Han, Elizabeth M. Bonachea & Jonathan L. Slaughter

  2. The Ohio State University College of Medicine, Columbus, OH, USA

    Rachel Han, Elizabeth M. Bonachea, Jonathan L. Slaughter, John D. Mahan & Tahagod Mohamed

  3. Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Kenneth Jackson & Sara Conroy

  4. Biostatistics Resource at Nationwide Children’s Hospital (BRANCH), Nationwide Children’s Hospital, Columbus, OH, USA

    Kenneth Jackson & Sara Conroy

  5. Center of Perinatal Research, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Jonathan L. Slaughter

  6. Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA

    Jonathan L. Slaughter

  7. Division of Pediatric Nephrology and Hypertension, Nationwide Children’s Hospital, Columbus, OH, USA

    John D. Mahan & Tahagod Mohamed

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  1. Rachel Han
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Contributions

RH conceptualized and designed the study, collected data, assisted with data analysis, drafted the initial manuscript, and reviewed and revised the manuscript. SC and KJ analyzed data, made figures and tables, and reviewed and revised the manuscript for important intellectual contents. EB, JS and JM reviewed and revised the manuscript for important intellectual contents. TM assisted with the study design and data analysis and critically reviewed and revised several drafts of the manuscript. All authors approve the final manuscript as submitted and agree to be accountable for all aspects of the study.

Corresponding author

Correspondence to Rachel Han.

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Competing interests

RH, SC, KJ, EB, JS, and TM have no conflicts of interest to disclose. JM serves on the advisory committee and speaker bureau for Ultragenyx and provides consultancy for OPKO.

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Han, R., Bonachea, E.M., Jackson, K. et al. Describing patterns in serum creatinine in infants with and without necrotizing enterocolitis. J Perinatol 43, 86–90 (2023). https://doi.org/10.1038/s41372-022-01482-7

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