TY - JOUR
T1 - Documentation of acute kidney injury at discharge from the neonatal intensive care unit and role of nephrology consultation
AU - Neonatal Kidney Collaborative
AU - Chmielewski, Jennifer
AU - Chaudhry, Paulomi M.
AU - Harer, Matthew W.
AU - Menon, Shina
AU - South, Andrew M.
AU - Chappell, Ashley
AU - Griffin, Russell
AU - Askenazi, David
AU - Jetton, Jennifer
AU - Starr, Michelle C.
AU - Ambalavanan, Namasivayam
AU - Selewski, David T.
AU - Sarkar, Subrata
AU - Kent, Alison
AU - Fletcher, Jeffery
AU - Abitbol, Carolyn L.
AU - DeFreitas, Marissa
AU - Duara, Shahnaz
AU - Charlton, Jennifer R.
AU - Swanson, Jonathan R.
AU - Guillet, Ronnie
AU - D’Angio, Carl
AU - Mian, Ayesa
AU - Rademacher, Erin
AU - Mhanna, Maroun J.
AU - Raina, Rupesh
AU - Kumar, Deepak
AU - Jetton, Jennifer G.
AU - Brophy, Patrick D.
AU - Colaizy, Tarah T.
AU - Klein, Jonathan M.
AU - Arikan, Ayse Akcan
AU - Rhee, Christopher J.
AU - Goldstein, Stuart L.
AU - Nathan, Amy T.
AU - Kupferman, Juan C.
AU - Bhutada, Alok
AU - Rastogi, Shantanu
AU - Bonachea, Elizabeth
AU - Ingraham, Susan
AU - Mahan, John
AU - Nada, Arwa
AU - Cole, F. Sessions
AU - Davis, T. Keefe
AU - Dower, Joshua
AU - Milner, Lawrence
AU - Smith, Alexandra
AU - Fuloria, Mamta
AU - Reidy, Kimberly
AU - Kaskel, Frederick J.
N1 - Funding Information:
All authors report no real or perceived conflicts of interest that could affect the study design, collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the manuscript for publication. For full disclosure, we provide the additional list of authors’ other funding not directly related to this study. DA consults for and received research/education grants with Baxter, Medtronic, Nuwellis, Bioporto and Seastar. He has patent pending inventions in the area of neonatal nephrology. AS reports receiving grant funding for studies not related to this work, grants NHLBI K23 HL148394, L40 HL148910, and R01 HL146818. MS is supported in part by the Indiana University School of Medicine Physician Scientist Initiative. No other disclosures were reported.
Funding Information:
Cincinnati Children’s Hospital Center for Acute Care Nephrology provided funding to create and maintain the Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) study Medidata Rave electronic database. The Pediatric and Infant Center for Acute Nephrology (PICAN) provided support for web meetings and for the Neonatal Kidney Collaborative (NKC) steering committee annual meeting at The University of Alabama at Birmingham (UAB), as well as support for 2 of the AWAKEN study investigators at UAB (D.A. and R.G.). PICAN is part of the Department of Pediatrics at UAB and is funded by Children’s of Alabama hospital, UAB Department of Pediatrics, UAB School of Medicine, and UAB Center for Clinical and Translational Sciences (National Institutes of Health grant UL1TR001417). Finally, the AWAKEN study at The University of New Mexico was supported by the Clinical and Translational Science Center at The University of New Mexico (National Institutes of Health grant UL1TR001449) and by The University of Iowa Institute for Clinical and Translational Science (grant U54TR001356). The AWAKEN study investigators at the Canberra Hospital at the Australian National University Medical School were supported by the Canberra Hospital Private Practice Fund, and investigators at University of Virginia Children’s Hospital were supported by a 100 Women Who Care Grant from the 100 Women Charitable Foundation. The funding sources for this study had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2022/7
Y1 - 2022/7
N2 - Objective: To investigate whether NICU discharge summaries documented neonatal AKI and estimate if nephrology consultation mediated this association. Study design: Secondary analysis of AWAKEN multicenter retrospective cohort. Exposures: AKI severity and diagnostic criteria. Outcome: AKI documentation on NICU discharge summaries using multivariable logistic regression to estimate associations and test for causal mediation. Results: Among 605 neonates with AKI, 13% had documented AKI. Those with documented AKI were more likely to have severe AKI (70.5% vs. 51%, p < 0.001) and SCr-only AKI (76.9% vs. 50.1%, p = 0.04). Nephrology consultation mediated 78.0% (95% CL 46.5–109.4%) of the total effect of AKI severity and 82.8% (95% CL 70.3–95.3%) of the total effect of AKI diagnostic criteria on documentation. Conclusion: We report a low prevalence of AKI documentation at NICU discharge. AKI severity and SCr-only AKI increased odds of AKI documentation. Nephrology consultation mediated the associations of AKI severity and diagnostic criteria with documentation.
AB - Objective: To investigate whether NICU discharge summaries documented neonatal AKI and estimate if nephrology consultation mediated this association. Study design: Secondary analysis of AWAKEN multicenter retrospective cohort. Exposures: AKI severity and diagnostic criteria. Outcome: AKI documentation on NICU discharge summaries using multivariable logistic regression to estimate associations and test for causal mediation. Results: Among 605 neonates with AKI, 13% had documented AKI. Those with documented AKI were more likely to have severe AKI (70.5% vs. 51%, p < 0.001) and SCr-only AKI (76.9% vs. 50.1%, p = 0.04). Nephrology consultation mediated 78.0% (95% CL 46.5–109.4%) of the total effect of AKI severity and 82.8% (95% CL 70.3–95.3%) of the total effect of AKI diagnostic criteria on documentation. Conclusion: We report a low prevalence of AKI documentation at NICU discharge. AKI severity and SCr-only AKI increased odds of AKI documentation. Nephrology consultation mediated the associations of AKI severity and diagnostic criteria with documentation.
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U2 - 10.1038/s41372-022-01424-3
DO - 10.1038/s41372-022-01424-3
M3 - Article
C2 - 35676535
AN - SCOPUS:85133821481
SN - 0743-8346
VL - 42
SP - 930
EP - 936
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 7
ER -