Neonatal acute kidney injury and neurodevelopmental impairment: investigating associations in very low birthweight infants

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Abstract
Objective: Associations between neonatal acute kidney injury (AKI) and neurodevelopmental impairment (NDI) remains understudied. We hypothesized AKI is associated with NDI in very low birthweight (VLBW) infants. Study design: A single-center, retrospective cohort study of VLBW infants with and without AKI during hospitalization evaluated in developmental clinic at 18 to 35 months of age. Associations between AKI and NDI were examined using bivariate and multivariable generalized linear mixed modeling. Result: Of 203 infants included, 64 (32%) experienced neonatal AKI and 76 (37%) developed NDI. The relative risk of NDI was significantly higher in those with AKI (RR 1.67, 95% CI 1.18–2.36; p < 0.01). In multivariable analysis, AKI was not an independent predictor of NDI (aRR 1.07, 95% CI 0.68–1.68; p = 0.77). Conclusion: In bivariate analyses, AKI was a significant predictor of NDI. In a multivariable model, AKI was no longer an independent predictor of NDI. Further investigation is warranted.

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