TY - JOUR
T1 - Association of early dysnatremia with mortality in the neonatal intensive care unit
T2 - results from the AWAKEN study
AU - the AWAKEN Study Group
AU - Basalely, Abby M.
AU - Griffin, Russell
AU - Gist, Katja M.
AU - Guillet, Ronnie
AU - Askenazi, David J.
AU - Charlton, Jennifer R.
AU - Selewski, David T.
AU - Fuloria, Mamta
AU - Kaskel, Frederick J.
AU - Reidy, Kimberly J.
AU - Askenazi, David
AU - Ambalavanan, N.
AU - Goldstein, Stuart
AU - Nathan, Amy
AU - Greenberg, James
AU - Kent, Alison
AU - Fletcher, Jeffrey
AU - Sethna, Farah
AU - Soranno, Danielle
AU - Gien, Jason
AU - Gist, Katja
AU - Fuloria, Mamta
AU - Reidy, Kim
AU - Kaskel, Frederick
AU - Uy, Natalie
AU - Revenis, Mary
AU - Perrazo, Sofia
AU - Rastogi, Shantanu
AU - Schwartz, George
AU - D’Angio, Carl T.
AU - Rademacher, Erin
AU - El Samra, Ahmed
AU - Mian, Ayesa
AU - Kupferman, Juan
AU - Bhutada, Alok
AU - Zappitelli, Michael
AU - Wintermark, Pia
AU - Wazir, Sanjay
AU - Sethi, Sidharth
AU - Dubey, Sandeep
AU - Mhanna, Maroun
AU - Kumar, Deepak
AU - Raina, Rupesh
AU - Ingraham, Susan
AU - Nada, Arwa
AU - Bonachea, Elizabeth
AU - Fine, Richard
AU - Woroniecki, Robert
AU - Sridhar, Shanthy
AU - Ariken, Ayse
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2022/10
Y1 - 2022/10
N2 - Objective: To determine the association of dysnatremia in the first postnatal week and risk of acute kidney injury (AKI) and mortality. Study design: A secondary analysis of 1979 neonates in the AWAKEN cohort evaluated the association of dysnatremia with (1) AKI in the first postnatal week and (2) mortality, utilizing time-varying Cox proportional hazard models. Result: Dysnatremia developed in 50.2% of the cohort and was not associated with AKI. Mortality was associated with hyponatremia (HR 2.15, 95% CI 1.07–4.31), hypernatremia (HR 4.23, 95% CI 2.07–8.65), and combined hypo/hypernatremia (HR 6.39, 95% CI 2.01–14.01). In stratified models by AKI-status, hypernatremia and hypo/hypernatremia increased risk of mortality in neonates without AKI. Conclusion: Dysnatremia within the first postnatal week was associated with increased risk of mortality. Hypernatremia and combined hypo/hypernatremia remained significantly associated with mortality in neonates without AKI. This may reflect fluid strategies kidney injury independent of creatinine and urine-output defined AKI, and/or systemic inflammation.
AB - Objective: To determine the association of dysnatremia in the first postnatal week and risk of acute kidney injury (AKI) and mortality. Study design: A secondary analysis of 1979 neonates in the AWAKEN cohort evaluated the association of dysnatremia with (1) AKI in the first postnatal week and (2) mortality, utilizing time-varying Cox proportional hazard models. Result: Dysnatremia developed in 50.2% of the cohort and was not associated with AKI. Mortality was associated with hyponatremia (HR 2.15, 95% CI 1.07–4.31), hypernatremia (HR 4.23, 95% CI 2.07–8.65), and combined hypo/hypernatremia (HR 6.39, 95% CI 2.01–14.01). In stratified models by AKI-status, hypernatremia and hypo/hypernatremia increased risk of mortality in neonates without AKI. Conclusion: Dysnatremia within the first postnatal week was associated with increased risk of mortality. Hypernatremia and combined hypo/hypernatremia remained significantly associated with mortality in neonates without AKI. This may reflect fluid strategies kidney injury independent of creatinine and urine-output defined AKI, and/or systemic inflammation.
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U2 - 10.1038/s41372-021-01260-x
DO - 10.1038/s41372-021-01260-x
M3 - Article
C2 - 34775486
AN - SCOPUS:85119602103
SN - 0743-8346
VL - 42
SP - 1353
EP - 1360
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 10
ER -