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Renal tissue oxygenation and development of AKI in preterm neonates born < 32 weeks’ gestational age in the first week of age

Journal of Perinatology volume 44, pages 434–438 (2024)Cite this article

Subjects

Abstract

Objective

To evaluate the relationship between regional renal saturation of oxygen (RrSO2) changes and serum creatinine (SCr) during the first eight days of age for preterm neonates born < 32 weeks’ gestational age.

Design

Post-hoc analysis of multicenter prospectively measured neonatal RrSO2 values collected during the first 8 days of age in neonates born at < 32 weeks’ gestation. Acute kidney injury (AKI) was defined by the neonatal modified Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Variables were compared between groups of neonates with and with AKI.

Results

One hundred nine neonates were included and 561 SCr values were obtained. Eight participants developed AKI by SCr criteria. A 10-percentage point increase in mean %RrSO2 was associated with a 40% decrease in risk of AKI (95%CI: 9.6–61%; p = 0.016).

Conclusions

Increases in mean %RrSO2 in neonates born at < 32 weeks’ GA were associated with a decreased risk of AKI. These findings support the design of further prospective trials utilizing RrSO2 monitoring to evaluate new therapies or clinical protocols to prevent and treat neonatal AKI.

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Fig. 1: Renal oxygenation trends of individual subjects with acute kidney injury.
Fig. 2: Association between average renal oxygenation (%RrSO2) (horizontal axis) and predicted probability of not having acute kidney injury (AKI) (vertical axis).
Fig. 3: Scatterplot of changes in serum creatinine (SCr) per each day of life (DOL) vs changes in renal oxygenation per each hour of life (HOL).

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Data availability

The data that support the findings of this study are not openly available but may be available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank the Meriter Foundation for funding the initial trial at UPHM. We would like to thank the families for agreeing to participate in the study.

Funding

The portion of the study completed at UPHM was funded by the Meriter Foundation.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Paige E. Condit & Matthew W. Harer

  2. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA

    Jennifer E. Chuck & Valerie Y. Chock

  3. Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Michael R. Lasarev

Authors
  1. Paige E. Condit
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  5. Matthew W. Harer
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Contributions

PEC: contributed to study design, interpretation of data, drafting and approval of manuscript, agrees to be accountable for all aspects of work. JEC: Acquisition of data, revision and approval of manuscript, agree to be accountable for all aspects of work. MRL: Analysis, and interpretation of data, drafting and approval of manuscript, agrees to be accountable for all aspects of work. VYC: contributed to study design, interpretation of data, revision and approvals of manuscript, agree to be accountable for all aspects of work. MWH: contributed to study design, patient enrollment, interpretation of data, revision and approval of manuscript, agrees to be accountable for all aspects of work.

Corresponding author

Correspondence to Paige E. Condit.

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Competing interests

The authors declare no competing interests.

Ethics approval

This study was approved by the Institutional Review Boards of UnityPoint-Meriter and Stanford University.

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Condit, P.E., Chuck, J.E., Lasarev, M.R. et al. Renal tissue oxygenation and development of AKI in preterm neonates born < 32 weeks’ gestational age in the first week of age. J Perinatol 44, 434–438 (2024). https://doi.org/10.1038/s41372-024-01873-y

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