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Characteristics of very low birthweight infants who have cortisol measurements taken and associations with neonatal acute kidney injury

Journal of Perinatology volume 44, pages 439–440 (2024)Cite this article

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The high incidence and adverse impact on outcomes of critically ill neonates with acute kidney injury (AKI) has become increasingly clearer over the past 20 years. The international multicenter Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) study demonstrated that AKI occurred in 30% of critically ill neonates [1, 2] and was independently associated with increased length of hospitalization and mortality [1]. In addition, the study identified several important risk factors for AKI including prematurity, necrotizing enterocolitis, nephrotoxic medication exposure, and low birthweight [1].

To date, it is unclear if there is an association between adrenal insufficiency and AKI. Cortisol is known to affect glucose homeostasis and hemodynamics, and any imbalance in the hypothalamic-pituitary-adrenocortical system could have deleterious effects including hypotension and subsequent AKI. In addition, the utility of cortisol measurements in neonates has been unstudied. The aim of our study was to [1] identify characteristics of very low birthweight (VLBW, <1500 g) infants who have cortisol measurements taken (CMT) during hospitalization and [2] investigate associations between infants who have CMT and AKI. We hypothesized that neonates with CMT during hospitalization will be significantly different than infants who did not have CMT and that an association exists between neonates with CMT during hospitalization and AKI.

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References

  1. Coleman C, Tambay Perez A, Selewski DT, Steflik HJ. Neonatal acute kidney injury. Front Pediatr. 2022;10:842544. https://doi.org/10.3389/fped.2022.842544. Published 2022 Apr 7.

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Funding

This project was funded in part by the David and Laura Stone Endowment for Advancement in Neonatal Medicine, Division of Neonatology, Medical University of South Carolina.

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Authors and Affiliations

  1. Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA

    Jeffrey E. King, Cassandra Coleman, David T. Selewski & Heidi J. Steflik

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

    Jill C. Newman

Authors
  1. Jeffrey E. King
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  2. Cassandra Coleman
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  3. David T. Selewski
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  4. Jill C. Newman
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  5. Heidi J. Steflik
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Contributions

HJS, JEK, and DS contributed substantially to the conception and design of this project, the acquisition, analysis, and interpretation of these data, the drafting and critical revision of this paper, and approved the final version as published and agree to be accountable for all aspects of the work. JEK and CC contributed substantially to the acquisition of the data for this work and the critical revision of this paper, and they approved the final version as published and agreed to be accountable for all aspects of the work. JCN contributed substantially to the analysis and interpretation of these data and the critical revision of this paper, and she approves the final version as published and agrees to be accountable for all aspects of the work.

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Correspondence to Jeffrey E. King.

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King, J.E., Coleman, C., Selewski, D.T. et al. Characteristics of very low birthweight infants who have cortisol measurements taken and associations with neonatal acute kidney injury. J Perinatol 44, 439–440 (2024). https://doi.org/10.1038/s41372-023-01795-1

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