TY - JOUR
T1 - Neonatal nephrotoxic medication exposure and early acute kidney injury
T2 - results from the AWAKEN study
AU - Neonatal Kidney Collaborative
AU - Steflik, Heidi J.
AU - Charlton, Jennifer R.
AU - Briley, Meagan
AU - Selewski, David T.
AU - Gist, Katja M.
AU - Hanna, Mina H.
AU - Askenazi, David
AU - Griffin, Russell
AU - Sarkar, Subrata
AU - Kent, Alison
AU - Fletcher, Jeffery
AU - Abitbol, Carolyn L.
AU - DeFreitas, Marissa
AU - Duara, Shahnaz
AU - Swanson, Jonathan R.
AU - Guillet, Ronnie
AU - D’Angio, Carl
AU - Mian, Ayesa
AU - Rademacher, Erin
AU - Mhanna, Maroun J.
AU - Raina, Rupesh
AU - Kumar, Deepak
AU - Ambalavanan, Namasivayam
AU - Arikan, Ayse Akcan
AU - Rhee, Christopher J.
AU - Goldstein, Stuart L.
AU - Nathan, Amy T.
AU - Kupferman, Juan C.
AU - Bhutada, Alok
AU - Rastogi, Shantanu
AU - Bonachea, Elizabeth
AU - Ingraham, Susan
AU - Mahan, John
AU - Nada, Arwa
AU - Jetton, Jennifer
AU - Brophy, Patrick D.
AU - Colaizy, Tarah T.
AU - Klein, Jonathan M.
AU - Cole, F. Sessions
AU - Davis, T. Keefe
AU - Dower, Joshua
AU - Milner, Lawrence
AU - Smith, Alexandra
AU - Fuloria, Mamta
AU - Reidy, Kimberly
AU - Kaskel, Frederick J.
AU - Soranno, Danielle E.
AU - Gien, Jason
AU - Woroniecki, Robert
AU - Sridhar, Shanthy
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2023/8
Y1 - 2023/8
N2 - Background: We aimed to describe nephrotoxic medication exposure and investigate associations between exposure and acute kidney injury (AKI) in the neonatal intensive care unit during the first postnatal week. Design/methods: Secondary analysis of the AWAKEN cohort. We evaluated nephrotoxic medication exposure during the first postnatal week and associations with AKI using time-varying Cox proportional hazard regressions models. Nephrotoxic medication exposure categories were defined as: no nephrotoxic medication, nephrotoxic medications excluding aminoglycosides, aminoglycoside alone, and aminoglycoside and another nephrotoxic medication. Results: Of 2162 neonates, 1616 (74.7%) received ≥1 nephrotoxic medication. Aminoglycoside receipt was most common (72%). AKI developed in 211(9.8%) neonates and was associated with a nephrotoxic medication exposure (p < 0.01). Nephrotoxic medication exposures including a nephrotoxic medication excluding aminoglycoside (aHR 3.14, 95% CI 1.31–7.55) and aminoglycoside and another nephrotoxic medication (aHR 4.79, 95% CI 2.19–10.50) were independently associated with AKI and severe AKI (stage 2/3), respectively. Conclusions: Nephrotoxic medication exposure in critically ill infants is common during the first postnatal week. Specific nephrotoxic medication exposure, principally aminoglycosides with another nephrotoxic medication, are independently associated with early AKI.
AB - Background: We aimed to describe nephrotoxic medication exposure and investigate associations between exposure and acute kidney injury (AKI) in the neonatal intensive care unit during the first postnatal week. Design/methods: Secondary analysis of the AWAKEN cohort. We evaluated nephrotoxic medication exposure during the first postnatal week and associations with AKI using time-varying Cox proportional hazard regressions models. Nephrotoxic medication exposure categories were defined as: no nephrotoxic medication, nephrotoxic medications excluding aminoglycosides, aminoglycoside alone, and aminoglycoside and another nephrotoxic medication. Results: Of 2162 neonates, 1616 (74.7%) received ≥1 nephrotoxic medication. Aminoglycoside receipt was most common (72%). AKI developed in 211(9.8%) neonates and was associated with a nephrotoxic medication exposure (p < 0.01). Nephrotoxic medication exposures including a nephrotoxic medication excluding aminoglycoside (aHR 3.14, 95% CI 1.31–7.55) and aminoglycoside and another nephrotoxic medication (aHR 4.79, 95% CI 2.19–10.50) were independently associated with AKI and severe AKI (stage 2/3), respectively. Conclusions: Nephrotoxic medication exposure in critically ill infants is common during the first postnatal week. Specific nephrotoxic medication exposure, principally aminoglycosides with another nephrotoxic medication, are independently associated with early AKI.
UR - https://www.scopus.com/pages/publications/85153703180
U2 - 10.1038/s41372-023-01684-7
DO - 10.1038/s41372-023-01684-7
M3 - Article
C2 - 37100984
AN - SCOPUS:85153703180
SN - 0743-8346
VL - 43
SP - 1029
EP - 1037
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 8
ER -