Risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancy
Introduction Nephrotoxic medication (NTM) is one of the common causes of acute kidney injury (AKI) in critically ill infants. Current knowledge about the long-term effects of NTM exposure and associated AKI during the neonatal period and early infancy is limited. Hence, we aimed to explore the risk...
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| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2218486 |
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| author | Priyanka Ameta Christine Stoops David J. Askenazi |
| author_facet | Priyanka Ameta Christine Stoops David J. Askenazi |
| author_sort | Priyanka Ameta |
| collection | DOAJ |
| description | Introduction Nephrotoxic medication (NTM) is one of the common causes of acute kidney injury (AKI) in critically ill infants. Current knowledge about the long-term effects of NTM exposure and associated AKI during the neonatal period and early infancy is limited. Hence, we aimed to explore the risk of chronic kidney disease (CKD) after NTM-AKI in this age group.Methods We performed a cross-sectional study including children 2–7 years of age, who had a history of high NTM exposure during NICU hospitalization. Cases and controls were defined as children who developed AKI and who did not develop AKI after NTM exposure, respectively. The primary outcome of interest was to explore the prevalence of composite CKD. In addition, we explored differences in urinary biomarker kidney injury molecule-1 (KIM-1) between the groups.Results We enrolled 48 children, 18 cases and 30 controls in which 25/48 (52%) had at least one finding of CKD. The composite CKD outcome tended to be higher in cases vs controls (61.1% vs. 46.6%, odds ratio = 1.79 (95% confidence interval 0.54-5.8)); however, this was not statistically significant. Median urinary KIM-1 value trended higher in controls, 0.367(0.23-0.59) vs. 0.20 (IQR 0.11-0.47), which was not statistically significant.Conclusion In this study, 52% of children exposed to NTM had at least one marker of CKD at a median age of 5 years. Multicenter, large prospective studies are needed to improve our understanding of the natural course of NTM-AKI and to determine risk factors and strategies to reduce CKD in this high-risk population. |
| format | Article |
| id | doaj-art-c4b7670c993a4e4493e2d172ee765daa |
| institution | OA Journals |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-c4b7670c993a4e4493e2d172ee765daa2025-08-20T02:16:10ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2218486Risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancyPriyanka Ameta0Christine Stoops1David J. Askenazi2Pediatric Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USANeonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USAPediatric Nephrology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USAIntroduction Nephrotoxic medication (NTM) is one of the common causes of acute kidney injury (AKI) in critically ill infants. Current knowledge about the long-term effects of NTM exposure and associated AKI during the neonatal period and early infancy is limited. Hence, we aimed to explore the risk of chronic kidney disease (CKD) after NTM-AKI in this age group.Methods We performed a cross-sectional study including children 2–7 years of age, who had a history of high NTM exposure during NICU hospitalization. Cases and controls were defined as children who developed AKI and who did not develop AKI after NTM exposure, respectively. The primary outcome of interest was to explore the prevalence of composite CKD. In addition, we explored differences in urinary biomarker kidney injury molecule-1 (KIM-1) between the groups.Results We enrolled 48 children, 18 cases and 30 controls in which 25/48 (52%) had at least one finding of CKD. The composite CKD outcome tended to be higher in cases vs controls (61.1% vs. 46.6%, odds ratio = 1.79 (95% confidence interval 0.54-5.8)); however, this was not statistically significant. Median urinary KIM-1 value trended higher in controls, 0.367(0.23-0.59) vs. 0.20 (IQR 0.11-0.47), which was not statistically significant.Conclusion In this study, 52% of children exposed to NTM had at least one marker of CKD at a median age of 5 years. Multicenter, large prospective studies are needed to improve our understanding of the natural course of NTM-AKI and to determine risk factors and strategies to reduce CKD in this high-risk population.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2218486Nephrotoxic medicationacute kidney injurychronic kidney disease |
| spellingShingle | Priyanka Ameta Christine Stoops David J. Askenazi Risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancy Renal Failure Nephrotoxic medication acute kidney injury chronic kidney disease |
| title | Risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancy |
| title_full | Risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancy |
| title_fullStr | Risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancy |
| title_full_unstemmed | Risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancy |
| title_short | Risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancy |
| title_sort | risk of chronic kidney disease in children who developed acute kidney injury secondary to nephrotoxic medication exposure in infancy |
| topic | Nephrotoxic medication acute kidney injury chronic kidney disease |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2218486 |
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