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



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.


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%).


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.

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.


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

Author information

Authors and Affiliations



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 (2022).

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