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Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study
Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study
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Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study
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Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study
Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study

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Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study
Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study
Journal Article

Neonatal nephrotoxic medication exposure and early acute kidney injury: results from the AWAKEN study

Dow
2023
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Overview
BackgroundWe aimed to describe nephrotoxic medication exposure and investigate associations between exposure and acute kidney injury (AKI) in the neonatal intensive care unit during the first postnatal week.Design/methodsSecondary analysis of the AWAKEN cohort. We evaluated nephrotoxic medication exposure during the first postnatal week and associations with AKI using time-varying Cox proportional hazard regressions models. Nephrotoxic medication exposure categories were defined as: no nephrotoxic medication, nephrotoxic medications excluding aminoglycosides, aminoglycoside alone, and aminoglycoside and another nephrotoxic medication.ResultsOf 2162 neonates, 1616 (74.7%) received ≥1 nephrotoxic medication. Aminoglycoside receipt was most common (72%). AKI developed in 211(9.8%) neonates and was associated with a nephrotoxic medication exposure (p < 0.01). Nephrotoxic medication exposures including a nephrotoxic medication excluding aminoglycoside (aHR 3.14, 95% CI 1.31–7.55) and aminoglycoside and another nephrotoxic medication (aHR 4.79, 95% CI 2.19–10.50) were independently associated with AKI and severe AKI (stage 2/3), respectively.ConclusionsNephrotoxic medication exposure in critically ill infants is common during the first postnatal week. Specific nephrotoxic medication exposure, principally aminoglycosides with another nephrotoxic medication, are independently associated with early AKI.