TY - JOUR
T1 - The impact of increased awareness of acute kidney injury in the Neonatal Intensive Care Unit on acute kidney injury incidence and reporting
T2 - results of a retrospective cohort study
AU - Starr, Michelle C.
AU - Kula, Alexander
AU - Lieberman, Joshua
AU - Menon, Shina
AU - Perkins, Anthony J.
AU - Lam, Teresa
AU - Chabra, Shilpi
AU - Hingorani, Sangeeta
N1 - Funding Information:
Funding This study was supported in part by NIH T32DK007662 (MS, AK). The authors declare that they have no other relevant financial interests.
Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Objective: To evaluate the impact of nephrology integration in the NICU on acute kidney injury (AKI) incidence, provider reporting, and nephrology referral. Study design: Cohort study in a single-center NICU from January 2012 to December 2017 (n = 1464). We assessed the impact of clinical practice changes including neonatal-nephrology rounds on the incidence of AKI. Results: AKI occurred in 318 neonates (22%). AKI occurred less frequently in those admitted after clinical practice changes (P < 0.001). After multivariable adjustment, clinical practice changes were associated with reduced odds of AKI (adjusted odds ratio, 0.31; 95% CI 0.22–0.44, P < 0.001). Provider reporting of AKI improved (P < 0.001) and more neonates were referred for nephrology follow-up (P < 0.001). Conclusions: Increased nephrology integration in the NICU was associated with decreased AKI incidence. While recognition of AKI improved, AKI remained poorly reported and nephrology AKI follow-up did not routinely occur. This study supports the importance of increased nephrology involvement in the NICU.
AB - Objective: To evaluate the impact of nephrology integration in the NICU on acute kidney injury (AKI) incidence, provider reporting, and nephrology referral. Study design: Cohort study in a single-center NICU from January 2012 to December 2017 (n = 1464). We assessed the impact of clinical practice changes including neonatal-nephrology rounds on the incidence of AKI. Results: AKI occurred in 318 neonates (22%). AKI occurred less frequently in those admitted after clinical practice changes (P < 0.001). After multivariable adjustment, clinical practice changes were associated with reduced odds of AKI (adjusted odds ratio, 0.31; 95% CI 0.22–0.44, P < 0.001). Provider reporting of AKI improved (P < 0.001) and more neonates were referred for nephrology follow-up (P < 0.001). Conclusions: Increased nephrology integration in the NICU was associated with decreased AKI incidence. While recognition of AKI improved, AKI remained poorly reported and nephrology AKI follow-up did not routinely occur. This study supports the importance of increased nephrology involvement in the NICU.
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U2 - 10.1038/s41372-020-0725-y
DO - 10.1038/s41372-020-0725-y
M3 - Article
C2 - 32681064
AN - SCOPUS:85088029512
SN - 0743-8346
VL - 40
SP - 1301
EP - 1307
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 9
ER -