020 - Exploratory Analysis of Association between 25-hydroxyvitamin D and Neonatal Acute Kidney Injury in Extremely Preterm Infants
Saturday, April 26, 2025
2:30pm – 4:45pm HST
Publication Number: 20.4742
Mar Romero-Lopez, University of Texas Health Science at Houston, Houston, TX, United States; David Selewski, Medical University of South Carolina, Mount Pleasant, SC, United States; Mamta Naik, Children's Memorial Hermann Hospital, houston, TX, United States; Glenville Jones, Queen's University Faculty of Health Sciences, Kingston, ON, Canada; Martin Kaufmann, Queen's University, Kingston, ON, Canada; Claudia Pedroza, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Chenyue Huang, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Kimberly J. Reidy, The Children's Hospital at Montefiore, Bronx, NY, United States; Jennifer R Charlton, University of Virginia School of Medicine, charlottesville, VA, United States; Carol L. Wagner, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Jon E Tyson, The University of Texas Health Science Center, Houston, TX, United States; Heidi J.. Steflik, Medical University of South Carolina College of Medicine, Charleston, SC, United States
Assistant Professor of Pediatrics. Division of Neonatology UT Health Science Center Houston, Texas, United States
Background: Vitamin D deficiency is implicated in multiple neonatal pathologies. Emerging evidence suggests a potential link between vitamin D deficiency and renal dysfunction in adults, but the association between 25-hydroxyvitamin D (25-OH-D) concentrations and acute kidney injury (AKI) in preterm infants remains largely unexplored. Objective: Explore the association between 25-OH-D concentration and AKI in extremely preterm infants enrolled in the Vitamin D Extra Supplementation (ViDES) study (NCT 05459298). Design/Methods: This is an exploratory analysis of the first 90 patients enrolled in the ViDES study, a single-center, blinded, randomized trial comparing two enteral vitamin D supplementation regimens (800 IU/day vs. 400 IU/day) during the first 28 days after birth in extremely preterm infants. Inclusion criteria were birth at < 28 weeks' gestation or < 1,000 grams and < 96 hours after birth. Exclusion criteria included gestational age >32 weeks, major congenital anomalies, congenital nonbacterial infection, or severe illness. Serum creatinine was collected per routine practices (daily in the first 2 weeks and later at least twice a week during the first month) and 25-OH-D concentrations were obtained at enrollment and one month after birth. AKI was diagnosed retrospectively using the modified neonatal kidney disease: Improving Global Outcomes serum creatinine criteria. Associations between 25-OH-D concentrations and highest stage AKI were examined using Welch two-sample t-tests and one-way ANOVA. Results: Ninety infants with a mean birth weight of 782 ± 207 grams and mean gestational age at birth of 25± 2 weeks and 38% female were included in the analysis. The mean 25-OH-D concentrations were 20 ± 12 ng/mL and 52 ± 28 ng/mL at enrollment and one month after birth, respectively. AKI developed in 65/90 (72%) infants; the majority (48%) developed stage 1 AKI. No associations were detected between 25-OH-D concentration at enrollment or 1 month after birth and AKI (table).
Conclusion(s): In this preliminary analysis of the ViDES study, no associations were found between 25-OH-D levels and AKI in preterm infants. Following trial completion, future analyses will include examinations between study arms, subgroups stratified by gestational age, and varying vitamin D metabolites (including 3-epi-25-OH-D3 and 24,25-OH2D3).
