Recommended Citation
Furqan S, Vazzalwar R, Hasad M, Huma L, Singh M, Alwan S, Prazad P. Exploring the Association between Patent Ductus Arteriosus, its Management, and Acute Kidney Injury in Preterm Neonates. Poster presented at the Pediatric Academic Society Meeting; April 28, 2025; Honolulu, HI.
Presentation Notes
Poster presented at the Pediatric Academic Society Meeting; April 28, 2025; Honolulu, HI
Abstract
Objective: To examine the relationship between Patent Ductus Arteriosus (PDA) and Acute Kidney Injury (AKI) stages in preterm neonates with gestational age < 30 weeks, and to evaluate how different PDA management approaches influence AKI occurrence.Study Design: A Single-center retrospective cohort study conducted at a level 3 NICU between February 2020 and September 2023. All inborn and out–born neonates with gestational age <30 weeks admitted within 72 hours of birth were included. AKI was defined using neonatal-modified Kidney Disease-Improving Global Outcomes (KDIGO) criteria. PDA management strategies were categorized as conservative, pharmacological, or surgical intervention.Results: Of 166 neonates, 79 (47.6%) had PDA and 133 (80.1%) developed AKI. PDA was associated with higher AKI incidence (87.3% vs 73.6%, p=0.026), lower gestational age (GA) (26.7±2.1 vs 27.8±2.0 weeks, p<0.001), lower birth weight (BW) (927.8±285.6 vs 1065.4±348.9g, p=0.005), more delivery room intubations (64.6% vs 48.3%, p=0.042), higher serum creatinine weeks 2-4 (p<0.05), paradoxically higher GFR weeks 2-4 (p<0.01), altered fluid management (higher week 1, p=0.015; lower weeks 3-4, p<0.05), and increased diuretic use (furosemide weeks 1-4, p<0.01; thiazide weeks 2-4, p<0.001). AKI infants had lower maternal age, GA, BW, 1-minute Apgar scores (all p≤0.01), more delivery room interventions (p<0.05), longer mechanical ventilation (p=0.05), and more inotrope use (p=0.02). Stage 2 AKI trended higher with PDA (13.9% vs 5.7%, p=0.08). Coding-based AKI diagnosis was substantially lower than KDIGO criteria (8.4% vs 80.1%).Conclusion: PDA is significantly associated with increased AKI risk in extremely preterm neonates, with altered renal function, fluid management patterns, and increased diuretic requirements. The substantial under-recognition of AKI in clinical practice (8.4% coded vs 80.1% KDIGO-based) highlights the critical need for systematic AKI surveillance and standardized diagnostic criteria implementation in this high-risk population.
Type
Poster
Affiliations
Advocate Children's Hospital - Park Ridge