Acute Kidney Injury Associated with Late-Onset Neonatal Seps
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A Study was conducted to determine the incidence and severity of acute kidney injury (AKI) within 7 days of sepsis evaluation and to assess AKI duration and the association between AKI and 30-day mortality.

Retrospective, matched cohort study in a single-center level IV NICU was done. Eligible infants underwent sepsis evaluations at more than 72 hours of age during calendar years 2013-2018. Exposed infants (“cases”) were those with culture proven sepsis and antimicrobial duration more than 5 days. Non-exposed infants (“controls”) were matched 1:1 to exposed infants based on gestational and corrected gestational age, and had negative sepsis evaluations with antibiotic durations less than 48 hours.
Results:
--Among 203 episodes of late-onset sepsis, 40 (20%) developed AKI within 7 days following evaluation, and among 193 episodes with negative cultures, 16 (8%) resulted in AKI.
--Episodes of sepsis also led to greater AKI severity, compared with non-septic episodes. The timing of AKI onset and AKI duration did not differ between groups.
--Sepsis was associated with increased odds of developing AKI (aOR 3.0). AKI was associated with increased 30-day mortality (aOR 4.5).

Conclusively, Infants with late-onset sepsis had increased odds of AKI and greater AKI severity within 7 days of sepsis evaluation, compared with age-matched infants without sepsis. AKI was independently associated with increased 30-day mortality. Strategies to mitigate AKI in critically ill neonates with sepsis may improve outcomes.

Source: https://www.jpeds.com/article/S0022-3476(20)31505-5/fulltext?rss=yes
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