Relationship between acute kidney injury and brain MRI findings in asphyxiated newborns after therapeutic hypothermia
We hypothesized that acute kidney injury (AKI) in asphyxiated neonates treated with therapeutic hypothermia would be associated with hypoxic-ischemic lesions on brain magnetic resonance imaging (MRI). Medical records of 88 cooled neonates who had had brain MRI were reviewed. All neonates had serum c...
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| Published in: | Pediatric research Vol. 75; no. 3; p. 431 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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01.03.2014
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| ISSN: | 1530-0447, 1530-0447 |
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| Abstract | We hypothesized that acute kidney injury (AKI) in asphyxiated neonates treated with therapeutic hypothermia would be associated with hypoxic-ischemic lesions on brain magnetic resonance imaging (MRI).
Medical records of 88 cooled neonates who had had brain MRI were reviewed. All neonates had serum creatinine assessed before the start of cooling; at 24, 48, and 72 h through cooling; and then on day 5 or 7 of life. A neonatal modification of the Kidney Disease: Improving Global Outcomes guidelines was used to classify AKI. MRI images were evaluated by a neuroradiologist masked to outcomes. Outcome of interest was abnormal brain MRI at 7-10 d of life.
AKI was found in 34 (39%) of 88 neonates, with 15, 7, and 12 fulfilling criteria for stages 1, 2, and 3, respectively. Brain MRI abnormalities related to hypoxia-ischemia were present in 50 (59%) newborns. Abnormal MRI was more frequent in infants from the AKI group (AKI: 25 of 34, 73% vs. no AKI: 25 of 54, 46%; P = 0.012; odds ratio (OR) = 3.2; 95% confidence interval (CI) = 1.3-8.2). Multivariate analysis identified AKI (OR = 2.9; 95% CI = 1.1-7.6) to be independently associated with the primary outcome.
AKI is independently associated with the presence of hypoxic-ischemic lesions on postcooling brain MRI. |
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| AbstractList | We hypothesized that acute kidney injury (AKI) in asphyxiated neonates treated with therapeutic hypothermia would be associated with hypoxic-ischemic lesions on brain magnetic resonance imaging (MRI).
Medical records of 88 cooled neonates who had had brain MRI were reviewed. All neonates had serum creatinine assessed before the start of cooling; at 24, 48, and 72 h through cooling; and then on day 5 or 7 of life. A neonatal modification of the Kidney Disease: Improving Global Outcomes guidelines was used to classify AKI. MRI images were evaluated by a neuroradiologist masked to outcomes. Outcome of interest was abnormal brain MRI at 7-10 d of life.
AKI was found in 34 (39%) of 88 neonates, with 15, 7, and 12 fulfilling criteria for stages 1, 2, and 3, respectively. Brain MRI abnormalities related to hypoxia-ischemia were present in 50 (59%) newborns. Abnormal MRI was more frequent in infants from the AKI group (AKI: 25 of 34, 73% vs. no AKI: 25 of 54, 46%; P = 0.012; odds ratio (OR) = 3.2; 95% confidence interval (CI) = 1.3-8.2). Multivariate analysis identified AKI (OR = 2.9; 95% CI = 1.1-7.6) to be independently associated with the primary outcome.
AKI is independently associated with the presence of hypoxic-ischemic lesions on postcooling brain MRI. We hypothesized that acute kidney injury (AKI) in asphyxiated neonates treated with therapeutic hypothermia would be associated with hypoxic-ischemic lesions on brain magnetic resonance imaging (MRI).BACKGROUNDWe hypothesized that acute kidney injury (AKI) in asphyxiated neonates treated with therapeutic hypothermia would be associated with hypoxic-ischemic lesions on brain magnetic resonance imaging (MRI).Medical records of 88 cooled neonates who had had brain MRI were reviewed. All neonates had serum creatinine assessed before the start of cooling; at 24, 48, and 72 h through cooling; and then on day 5 or 7 of life. A neonatal modification of the Kidney Disease: Improving Global Outcomes guidelines was used to classify AKI. MRI images were evaluated by a neuroradiologist masked to outcomes. Outcome of interest was abnormal brain MRI at 7-10 d of life.METHODSMedical records of 88 cooled neonates who had had brain MRI were reviewed. All neonates had serum creatinine assessed before the start of cooling; at 24, 48, and 72 h through cooling; and then on day 5 or 7 of life. A neonatal modification of the Kidney Disease: Improving Global Outcomes guidelines was used to classify AKI. MRI images were evaluated by a neuroradiologist masked to outcomes. Outcome of interest was abnormal brain MRI at 7-10 d of life.AKI was found in 34 (39%) of 88 neonates, with 15, 7, and 12 fulfilling criteria for stages 1, 2, and 3, respectively. Brain MRI abnormalities related to hypoxia-ischemia were present in 50 (59%) newborns. Abnormal MRI was more frequent in infants from the AKI group (AKI: 25 of 34, 73% vs. no AKI: 25 of 54, 46%; P = 0.012; odds ratio (OR) = 3.2; 95% confidence interval (CI) = 1.3-8.2). Multivariate analysis identified AKI (OR = 2.9; 95% CI = 1.1-7.6) to be independently associated with the primary outcome.RESULTSAKI was found in 34 (39%) of 88 neonates, with 15, 7, and 12 fulfilling criteria for stages 1, 2, and 3, respectively. Brain MRI abnormalities related to hypoxia-ischemia were present in 50 (59%) newborns. Abnormal MRI was more frequent in infants from the AKI group (AKI: 25 of 34, 73% vs. no AKI: 25 of 54, 46%; P = 0.012; odds ratio (OR) = 3.2; 95% confidence interval (CI) = 1.3-8.2). Multivariate analysis identified AKI (OR = 2.9; 95% CI = 1.1-7.6) to be independently associated with the primary outcome.AKI is independently associated with the presence of hypoxic-ischemic lesions on postcooling brain MRI.CONCLUSIONAKI is independently associated with the presence of hypoxic-ischemic lesions on postcooling brain MRI. |
| Author | Bhagat, Indira Sarkar, Subrata Askenazi, David J Jordan, Brian K Bapuraj, J R Selewski, David T Dechert, Ronald E |
| Author_xml | – sequence: 1 givenname: Subrata surname: Sarkar fullname: Sarkar, Subrata organization: Department of Pediatrics & Communicable Diseases, Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan – sequence: 2 givenname: David J surname: Askenazi fullname: Askenazi, David J organization: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama – sequence: 3 givenname: Brian K surname: Jordan fullname: Jordan, Brian K organization: Department of Pediatrics & Communicable Diseases, Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan – sequence: 4 givenname: Indira surname: Bhagat fullname: Bhagat, Indira organization: Department of Pediatrics, St. Joseph Mercy Hospital, Ypsilanti, Michigan – sequence: 5 givenname: J R surname: Bapuraj fullname: Bapuraj, J R organization: Department of Radiology, University of Michigan, Ann Arbor, Michigan – sequence: 6 givenname: Ronald E surname: Dechert fullname: Dechert, Ronald E organization: Department of Pediatrics & Communicable Diseases, Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan – sequence: 7 givenname: David T surname: Selewski fullname: Selewski, David T organization: Department of Pediatrics & Communicable Diseases, Division of Nephrology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan |
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| SubjectTerms | Acute Kidney Injury - etiology Asphyxia Neonatorum - complications Asphyxia Neonatorum - pathology Humans Hypothermia, Induced Hypoxia-Ischemia, Brain - etiology Hypoxia-Ischemia, Brain - pathology Infant, Newborn Magnetic Resonance Imaging Odds Ratio |
| Title | Relationship between acute kidney injury and brain MRI findings in asphyxiated newborns after therapeutic hypothermia |
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