J Perinatol. 2025 Aug 4. doi: 10.1038/s41372-025-02379-x. Online ahead of print.
ABSTRACT
OBJECTIVES: To assess risk factors for acute kidney injury (AKI) in neonates with hypoxic ischemic encephalopathy (HIE) using KDIGO and Gupta definitions, and evaluate long-term kidney function.
METHODS: Retrospective study including 72 neonates with HIE and prospective evaluation of long-term kidney health data of 33 survivors.
RESULTS: AKI was detected in 49% using KDIGO and 32% using Gupta’s definition. KDIGO-defined AKI correlated with thrombocytopenia, low pH, transfusions need, nephrotoxic drugs, and furosemide use (p < 0.05). The Gupta definition showed additional associations with hypotension, cardiac dysfunction, and death (p < 0.05). In a logistic regression model, both definitions linked AKI to nephrotoxic drug exposure and transfusions. Follow-up assessments revealed elevated blood pressure in 12%, hyperfiltration in 18%, and proteinuria in 6% of survivors.
CONCLUSIONS: The Gupta definition may help identify AKI in an additional number of neonates with HIE. Long-term monitoring is essential for the early detection of kidney dysfunction.
PMID:40759728 | DOI:10.1038/s41372-025-02379-x
