Renal tissue oxygenation and development of AKI in preterm neonates born < 32 weeks' gestational age in the first week of age

Abstract

Objective: To evaluate the relationship between regional renal saturation of oxygen (RrSO₂) changes and serum creatinine (SCr) during the first eight days of age for preterm neonates born < 32 weeks' gestational age.

Design: Post-hoc analysis of multicenter prospectively measured neonatal RrSO₂ values collected during the first 8 days of age in neonates born at < 32 weeks' gestation. Acute kidney injury (AKI) was defined by the neonatal modified Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Variables were compared between groups of neonates with and with AKI.

Results: One hundred nine neonates were included and 561 SCr values were obtained. Eight participants developed AKI by SCr criteria. A 10-percentage point increase in mean %RrSO₂ was associated with a 40% decrease in risk of AKI (95%CI: 9.6-61%; p = 0.016).

Conclusions: Increases in mean %RrSO₂ in neonates born at < 32 weeks' GA were associated with a decreased risk of AKI. These findings support the design of further prospective trials utilizing RrSO₂ monitoring to evaluate new therapies or clinical protocols to prevent and treat neonatal AKI.