Dataset Information

The impact of increased awareness of acute kidney injury in the Neonatal Intensive Care Unit on acute kidney injury incidence and reporting: results of a retrospective cohort study.

ABSTRACT:

Objective

To evaluate the impact of nephrology integration in the NICU on acute kidney injury (AKI) incidence, provider reporting, and nephrology referral.

Study design

Cohort study in a single-center NICU from January 2012 to December 2017 (n?=?1464). We assessed the impact of clinical practice changes including neonatal-nephrology rounds on the incidence of AKI.

Results

AKI occurred in 318 neonates (22%). AKI occurred less frequently in those admitted after clinical practice changes (P?ConclusionsIncreased nephrology integration in the NICU was associated with decreased AKI incidence. While recognition of AKI improved, AKI remained poorly reported and nephrology AKI follow-up did not routinely occur. This study supports the importance of increased nephrology involvement in the NICU.

SUBMITTER: Starr MC

PROVIDER: S-EPMC7442645 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

The impact of increased awareness of acute kidney injury in the Neonatal Intensive Care Unit on acute kidney injury incidence and reporting: results of a retrospective cohort study.

Starr Michelle C MC Kula Alexander A Lieberman Joshua J Menon Shina S Perkins Anthony J AJ Lam Teresa T Chabra Shilpi S Hingorani Sangeeta S

Journal of perinatology : official journal of the California Perinatal Association 20200717 9

<h4>Objective</h4>To evaluate the impact of nephrology integration in the NICU on acute kidney injury (AKI) incidence, provider reporting, and nephrology referral.<h4>Study design</h4>Cohort study in a single-center NICU from January 2012 to December 2017 (n = 1464). We assessed the impact of clinical practice changes including neonatal-nephrology rounds on the incidence of AKI.<h4>Results</h4>AKI occurred in 318 neonates (22%). AKI occurred less frequently in those admitted after clinical pract ...[more]

PMID: 32681064

Similar Datasets

Project description:BackgroundWhether perioperative hyperchloremia can induce postoperative acute kidney injury (AKI) is controversial. We investigated the association between perioperative hyperchloremia and postoperative AKI in patients admitted to the intensive care unit (ICU) after surgery.MethodsWe performed a retrospective observational study of patients admitted to the surgical ICU at a single tertiary care hospital between January 2011 and June 2016. Our primary objective was to determine whether hyperchloremia or an increase in serum chloride levels was associated with postoperative AKI. Perioperative hyperchloremia was defined as serum chloride levels ??110 mmol·L-?1 during postoperative days (PODs) 0-3. The increase in serum chloride levels was defined as the difference between preoperative and maximum postoperative serum chloride levels during the first 3 days after surgery.ResultsOf the 7991 patients included in the final analysis, 1876 (23.5%) developed hyperchloremia during PODs 0-3, and 1187 (14.9%) developed postoperative AKI. Exposure to hyperchloremia during the first 3 days after surgery was not associated with postoperative AKI (odds ratio, 1.09; 95% confidence interval, 0.80-1.49; P =?0.571). However, among patients with preoperative chronic kidney disease stage ??3 (estimated glomerular filtration rate?<?60 mL·min-?1·1.73·m-?2), the incidence of postoperative AKI was higher in patients with an increase >?6 mmol·L-?1 in serum chloride levels than in patients with an increase ??1 mmol·L-?1 (odds ratio, 1.42; 95% confidence interval, 1.09-1.84; P =?0.009). In addition, the incidence of postoperative AKI stage ??2 was not associated with exposure to hyperchloremia or with the increase in serum chloride levels during PODs 0-3, regardless of preoperative kidney function.ConclusionsExposure to perioperative hyperchloremia is not associated with postoperative AKI in surgical ICU patients. However, in patients with moderate-to-severe chronic kidney disease (stage ??3), a substantial perioperative increase in serum chloride levels may reflect a higher risk of AKI.

Dataset Information

The impact of increased awareness of acute kidney injury in the Neonatal Intensive Care Unit on acute kidney injury incidence and reporting: results of a retrospective cohort study.

Objective

Study design

Results

Publications

The impact of increased awareness of acute kidney injury in the Neonatal Intensive Care Unit on acute kidney injury incidence and reporting: results of a retrospective cohort study.

Similar Datasets

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