Renal tissue oxygenation and development of AKI in preterm neonates born < 32 weeks’ gestational age in the first week of age

To evaluate the relationship between regional renal saturation of oxygen (RrSO₂) changes and serum creatinine (SCr) during the first eight days of age for preterm neonates born < 32 weeks’ gestational age.

Post-hoc analysis of multicenter prospectively measured neonatal RrSO₂ values collected during the first 8 days of age in neonates born at < 32 weeks’ gestation. Acute kidney injury (AKI) was defined by the neonatal modified Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Variables were compared between groups of neonates with and with AKI.

One hundred nine neonates were included and 561 SCr values were obtained. Eight participants developed AKI by SCr criteria. A 10-percentage point increase in mean %RrSO₂ was associated with a 40% decrease in risk of AKI (95%CI: 9.6–61%; p = 0.016).

Increases in mean %RrSO₂ in neonates born at < 32 weeks’ GA were associated with a decreased risk of AKI. These findings support the design of further prospective trials utilizing RrSO₂ monitoring to evaluate new therapies or clinical protocols to prevent and treat neonatal AKI.