WIP 06 - Exploring the Association between Patent Ductus Arteriosus, its Management, and Acute Kidney Injury in Preterm Neonates.

Publication Number: WIP 06.7608

Sarah Furqan, Advocate Children Hospital Park Ridge IL, Park Ridge, IL, United States; Manisha Singh, Advocate Children's Hospital - Park Ridge, Park Ridge, IL, United States; Seem Alwan, Advocate Children's Hospital - Park Ridge, Des Plaines, IL, United States; Mahbubul Hasan, Advocate Children's Hospital - Park Ridge, Colliervielle, TN, United States; Ramesh Vazzalwar, Advocate Children's Hospital - Park Ridge, Park Ridge, IL, United States; Preetha Prazad, Advocate Children's hospital- Park Ridge, Park Ridge, IL, United States

Background: Acute Kidney Injury (AKI) remains a significant but under-recognized morbidity in pre-term infants. Currently, there is no standardized definition for neonatal AKI, though efforts through the AWAKEN study have proposed modifications to the KDIGO (kidney disease: Improving Global Outcome) pediatric AKI criteria for neonatal application. Patent Ductus Arteriosus (PDA) has been implicated as a contributing factor to AKI, either independently or in relation to its treatments. The "ductal steal" phenomenon associated with PDA can lead to renal hypoperfusion, potentially contributing to AKI. However, the relationship between PDA management strategies and AKI remains unclear, as does the utility of echocardiographic markers in predicting AKI.

Objective: To determine the frequency of AKI according to Modified Neonatal KDIGO criteria among patients born at < 30 weeks Gestational age (GA) with PDA, to examine the impact of different PDA management approaches on AKI, and to explore the association between abdominal aorta reversed diastolic flow observed on echocardiography and AKI.

Design/Methods: This single-center, descriptive retrospective will study preterm infants born at < 30 weeks GA admitted to the NICU between February 2019 and September 2023. The study population includes inborn infants and those transferred within 72 hours of life. Exclusion criteria include major congenital anomalies, genetic syndromes, urogenital tract anomalies, and congenital heart disease. Subjects will be categorized into PDA and no-PDA cohorts, with further stratification by AKI stages (I, II, III) using Modified Neonatal KDIGO 2016 criteria. Data collection encompasses demographics, maternal risk factors, daily fluid intake/balance, urine output, and GFR calculations for the first 28 days of life. Additional variables include comorbidities, surfactant administration, and detailed echocardiographic parameters. Statistical analysis will employ mixed-effects logistic regression models and Bayesian hierarchical modeling, with significance set at p< 0.05.