Background

This study aimed to investigate the prevalence of acute kidney injury (AKI) in infants with varying degrees of hypoxic-ischemic encephalopathy (HIE) and its associated outcomes, including mortality and length of stay (LOS).

Methods

The study used the National Inpatient Sample (NIS) dataset from 2010 to 2018. Regression analysis was used to control confounding variables.

Results

Of 31,220,784 infants included in the study, 30,130 (0.1%) had HIE. The prevalence of AKI was significantly higher in infants with HIE (9.0%) compared to those without (0.04%), with an adjusted odds ratio (aOR) of 77.6 (CI:70.1–85.7, p < 0.001), with the highest prevalence of AKI in infants with severe HIE (19.7%), aOR:130 (CI: 107–159), p < 0.001). Infants with AKI had a higher mortality rate compared to those without AKI in those diagnosed with any degree of HIE (28.9% vs. 8.8%), aOR 3.5 (CI: 3.2–3.9, p < 0.001), particularly among those with severe HIE, aOR:1.4 (1.2–1.6, p < 0.001).

Conclusions

HIE is associated with an increased prevalence of AKI. Infants with severe HIE had the highest prevalence of AKI and associated mortality. The study highlights the need for close monitoring and early detection of AKI in infants with HIE, particularly those with severe HIE, to ameliorate the associated adverse outcomes.

中文翻译：

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婴儿缺氧缺血性脑病的急性肾损伤

背景

本研究旨在调查患有不同程度缺氧缺血性脑病（HIE）的婴儿中急性肾损伤（AKI）的患病率及其相关结局，包括死亡率和住院时间（LOS）。

方法

该研究使用了2010年至2018年的全国住院样本（NIS）数据集。使用回归分析来控制混杂变量。

结果

在该研究纳入的 31,220,784 名婴儿中，30,130 名 (0.1%) 患有 HIE。与没有 HIE 的婴儿 (0.04%) 相比，患有 HIE 的婴儿 AKI 患病率显着较高 (0.04%)，调整后的比值比 (aOR) 为 77.6 (CI:70.1–85.7，p  < 0.001)，患病率最高患有严重 HIE 的婴儿 AKI 的发生率 (19.7%)，aOR：130 (CI：107–159)，p  < 0.001）。在诊断为任何程度的 HIE 的婴儿中，与未患 AKI 的婴儿相比，患有 AKI 的婴儿死亡率更高（28.9% 比 8.8%），aOR 3.5（CI：3.2–3.9，p  < 0.001），特别是在患有严重 HIE 的婴儿中，aOR：1.4（1.2–1.6，p  < 0.001）。

结论

HIE 与 AKI 患病率增加有关。患有严重 HIE 的婴儿 AKI 患病率和相关死亡率最高。该研究强调需要对患有 HIE 的婴儿（尤其是患有严重 HIE 的婴儿）进行密切监测和早期发现 AKI，以改善相关的不良后果。