Acute kidney injury surveillance in the high-risk neonatal population following implementation of creatinine screening protocol. Acta Paediatr 2024 Apr;113(4):692-699
Date
12/12/2023Pubmed ID
38084834DOI
10.1111/apa.17055Scopus ID
2-s2.0-85179303306 (requires institutional sign-in at Scopus site) 1 CitationAbstract
AIM: Acute kidney injury (AKI) in neonates is associated with longer hospital stays and higher mortality rates. However, there is significant variability in prevalence rates of AKI and the true burden is incompletely understood. In November 2020, the University of Iowa Stead Family Children's Hospital Neonatal Intensive Care Unit implemented a creatinine screening protocol to enhance kidney function monitoring. We sought to evaluate adherence to the protocol to determine if increased surveillance led to increased detection of AKI events.
METHODS: A retrospective chart review was conducted for neonates born at <30 weeks' gestation admitted between 2015 and 2020. We reviewed 100 charts in both the pre (2015-2016) and post (2020-2021) implementation era of the AKI surveillance protocol. AKI was defined according to neonatal modified KDIGO criteria.
RESULTS: Following implementation of the protocol, neonates were significantly more likely to have creatinine checked (p < 0.001). Serum creatinine was drawn according to protocol guidelines 68% of the time, and 42% of patients (34/82) had an 80% or higher adherence to the protocol. There was a significant increase in detection of AKI in the post-protocol cohort (13/82, incidence of 16%) compared to the pre-protocol cohort (5/83, incidence of 6%), (p = 0.047).
CONCLUSION: The implementation of a serum creatinine screening protocol increased the frequency of creatinine draws and detection of AKI.
Author List
Gingrich AR, Hagenow AM, Steinbach EJ, Klein JM, Jetton JG, Misurac JMAuthor
Jennifer G. Jetton MD Chief, Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute Kidney InjuryChild
Creatinine
Female
Humans
Incidence
Infant, Newborn
Intensive Care Units, Neonatal
Retrospective Studies
Review Literature as Topic
Risk Factors