Renal tissue oxygenation and development of AKI in preterm neonates

Abstract Objective: To evaluate the relationship between regional renal saturation of oxygen (RrSO2) changes and serum creatinine (SCr) during the first week of age for preterm neonates. Design: Prospectively measured neonatal RrSO2 values collected during the first week of age in neonates. Acute kidney injury (AKI) was defined by the neonatal modified Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Variables were compared between groups. Results: 109 neonates were included and 561 SCr values were obtained. 8 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). Conclusions: 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 renal NIRS monitoring to evaluate new therapies or clinical protocols to prevent and treat neonatal AKI.