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. 2022 Feb;42(2):243-246.
doi: 10.1038/s41372-021-01198-0. Epub 2021 Sep 3.

Improving the identification of acute kidney injury in the neonatal ICU: three centers' experiences

Michelle C Starr  1 , Paulomi Chaudhry  2 , Allyson Brock  2 , Katherine Vincent  3 , Katherine Twombley  3 , Elizabeth M Bonachea  4 , Tahagod H Mohamed  4
Affiliations

Improving the identification of acute kidney injury in the neonatal ICU: three centers' experiences

Michelle C Starr et al. J Perinatol. 2022 Feb.

Abstract

Objective: To describe three different standardized approaches to improving neonatal acute kidney injury (AKI) identification and the impact on AKI identification, incidence, and nephrology consultation and referral.

Study design: A retrospective cohort study in three academic NICUs. We compared AKI identification, AKI incidence, nephrology consultation, and nephrology follow-up before and after implantation of local protocols to standardize neonatal AKI identification.

Result: Neonatal AKI identification improved in all three NICUs following protocol implementation (26-85%, P < 0.0001). Each center also saw increases in nephrology consultation (15-83%, P < 0.0001) and nephrology follow-up (7-73%, P < 0.0001). AKI incidence decreased significantly (21-12%, P < 0.0001).

Conclusion: Multiple strategies can be successfully operationalized to improve neonatal AKI identification. While different in approach, each strategy resulted in increased AKI identification and nephrology involvement. This study emphasizes the importance of local standardized approaches to AKI to improve AKI identification and nephrology involvement in the NICU.

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References

    1. Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE, et al. Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study. Lancet Child Adolesc Health. 2017;1:184–94. - DOI
    1. Askenazi D, Abitbol C, Boohaker L, Griffin R, Raina R, Dower J, et al. Optimizing the AKI definition during first postnatal week using assessment of worldwide acute kidney injury epidemiology in neonates (AWAKEN) cohort. Pediatr Res. 2019;85:329–38. - DOI
    1. Charlton JR, Boohaker L, Askenazi D, Brophy PD, D’Angio C, Fuloria M, et al. Incidence and risk factors of early onset neonatal AKI. Clin J Am Soc Nephrol. 2019;14:184–95. - DOI
    1. Charlton JR, Boohaker L, Askenazi D, Brophy PD, Fuloria M, Gien J, et al. Late onset neonatal acute kidney injury: results from the AWAKEN study. Pediatr Res. 2019;85:339–48. - DOI
    1. Selewski DT, Charlton JR, Jetton JG, Guillet R, Mhanna MJ, Askenazi DJ, et al. Neonatal acute kidney injury. Pediatrics. 2015;136:e463–73. - DOI