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Association of early dysnatremia with mortality in the neonatal intensive care unit: results from the AWAKEN study. J Perinatol 2022 Oct;42(10):1353-1360

Date

11/15/2021

Pubmed ID

34775486

Pubmed Central ID

PMC10228559

DOI

10.1038/s41372-021-01260-x

Scopus ID

2-s2.0-85119602103 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

OBJECTIVE: To determine the association of dysnatremia in the first postnatal week and risk of acute kidney injury (AKI) and mortality.

STUDY DESIGN: A secondary analysis of 1979 neonates in the AWAKEN cohort evaluated the association of dysnatremia with (1) AKI in the first postnatal week and (2) mortality, utilizing time-varying Cox proportional hazard models.

RESULT: Dysnatremia developed in 50.2% of the cohort and was not associated with AKI. Mortality was associated with hyponatremia (HR 2.15, 95% CI 1.07-4.31), hypernatremia (HR 4.23, 95% CI 2.07-8.65), and combined hypo/hypernatremia (HR 6.39, 95% CI 2.01-14.01). In stratified models by AKI-status, hypernatremia and hypo/hypernatremia increased risk of mortality in neonates without AKI.

CONCLUSION: Dysnatremia within the first postnatal week was associated with increased risk of mortality. Hypernatremia and combined hypo/hypernatremia remained significantly associated with mortality in neonates without AKI. This may reflect fluid strategies kidney injury independent of creatinine and urine-output defined AKI, and/or systemic inflammation.

Author List

Basalely AM, Griffin R, Gist KM, Guillet R, Askenazi DJ, Charlton JR, Selewski DT, Fuloria M, Kaskel FJ, Reidy KJ, AWAKEN Study Group

Author

Jennifer G. Jetton MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Acute Kidney Injury
Creatinine
Humans
Hypernatremia
Hyponatremia
Infant, Newborn
Intensive Care Units, Neonatal
Retrospective Studies
Risk Factors