To evaluate serum creatinine (SCr) patterns and the development of acute kidney injury (AKI), as potential biomarkers of necrotizing enterocolitis (NEC).
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.
This is a preview of subscription content, access via your institution
Subscribe to Journal
Get full journal access for 1 year
only $9.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
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.
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.
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.
Neu J, Walker WA. Necrotizing enterocolitis. N. Engl J Med. 2011;364:255–64.
Meister AL, Doheny KK, Travagli RA. Necrotizing enterocolitis: It’s not all in the gut. 2020;245:85–95.
Ward RM, Beachy JC. Neonatal complications following preterm birth. BJOG: Int J Obstet Gynaecol. 2003;110:8–16.
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.
Ng PC. Biomarkers of necrotising enterocolitis. Semin Fetal Neonatal Med. 2014;19:33–8.
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.
Jetton JG, Askenazi DJ. Update on acute kidney injury in the neonate. Curr Opin Pediatr. 2012;24:191–6.
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.
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.
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.
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.
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.
This research was supported by the Ohio Perinatal Research Network of Nationwide Children’s Hospital.
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.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Han, R., Bonachea, E.M., Jackson, K. et al. Describing patterns in serum creatinine in infants with and without necrotizing enterocolitis. J Perinatol (2022). https://doi.org/10.1038/s41372-022-01482-7