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. Houston 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).
