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Kidney outcomes in early adolescence following perinatal asphyxia and hypothermia-treated hypoxic-ischaemic encephalopathy

Robertsson Grossmann, Katarina ; Vishnevskaya, Liya ; Diaz Ruiz, Sandra LU ; Kublickiene, Karolina ; Bárány, Peter ; Blennow, Mats and Chromek, Milan LU (2023) In Pediatric Nephrology 38(4). p.1205-1214
Abstract

Background: Acute kidney injury (AKI) remains common among infants with hypothermia-treated hypoxic-ischaemic encephalopathy (HIE). Little is known about long-term kidney outcomes following hypothermia treatment. We recently reported that 21% of survivors of hypothermia-treated HIE had decreased estimated glomerular filtration rate (eGFR) based on plasma creatinine in early adolescence. Here, we assessed kidney functions more comprehensively in our population-based cohort of children born in Stockholm 2007–2009 with a history of hypothermia-treated HIE. Methods: At 10–12 years of age, we measured cystatin C (cyst C) to estimate GFR. Children with decreased cyst C eGFR also underwent iohexol clearance examination. We measured... (More)

Background: Acute kidney injury (AKI) remains common among infants with hypothermia-treated hypoxic-ischaemic encephalopathy (HIE). Little is known about long-term kidney outcomes following hypothermia treatment. We recently reported that 21% of survivors of hypothermia-treated HIE had decreased estimated glomerular filtration rate (eGFR) based on plasma creatinine in early adolescence. Here, we assessed kidney functions more comprehensively in our population-based cohort of children born in Stockholm 2007–2009 with a history of hypothermia-treated HIE. Methods: At 10–12 years of age, we measured cystatin C (cyst C) to estimate GFR. Children with decreased cyst C eGFR also underwent iohexol clearance examination. We measured urine-albumin/creatinine ratio, blood pressure (BP) and kidney volume on magnetic resonance imaging. Fibroblast growth factor 23 (FGF 23) levels in plasma were assessed by enzyme-linked immunosorbent assay (ELISA). Outcomes were compared between children with and without a history of neonatal AKI. Results: Forty-seven children participated in the assessment. Two children (2/42) had decreased cyst C eGFR, for one of whom iohexol clearance confirmed mildly decreased GFR. One child (1/43) had Kidney Disease Improving Global Outcomes (KDIGO) category A2 albuminuria, and three (3/45) had elevated office BP. Subsequent ambulatory 24-h BP measurement confirmed high normal BP in one case only. No child had hypertension. Kidney volume and FGF 23 levels were normal in all children. There was no difference in any of the parameters between children with and without a history of neonatal AKI. Conclusion: Renal sequelae were rare in early adolescence following hypothermia-treated HIE regardless of presence or absence of neonatal AKI. Graphical abstract: [Figure not available: see fulltext.].

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute kidney injury, Chronic kidney disease, Hypothermia treatment, Hypoxic-ischaemic encephalopathy, Long-term outcome, Perinatal asphyxia
in
Pediatric Nephrology
volume
38
issue
4
pages
1205 - 1214
publisher
Springer
external identifiers
  • scopus:85136198415
  • pmid:35976440
ISSN
0931-041X
DOI
10.1007/s00467-022-05705-z
language
English
LU publication?
yes
id
eea3b63d-97b1-443a-8aff-9d9cdd7bf64c
date added to LUP
2022-10-20 12:52:38
date last changed
2024-06-27 21:35:29
@article{eea3b63d-97b1-443a-8aff-9d9cdd7bf64c,
  abstract     = {{<p>Background: Acute kidney injury (AKI) remains common among infants with hypothermia-treated hypoxic-ischaemic encephalopathy (HIE). Little is known about long-term kidney outcomes following hypothermia treatment. We recently reported that 21% of survivors of hypothermia-treated HIE had decreased estimated glomerular filtration rate (eGFR) based on plasma creatinine in early adolescence. Here, we assessed kidney functions more comprehensively in our population-based cohort of children born in Stockholm 2007–2009 with a history of hypothermia-treated HIE. Methods: At 10–12 years of age, we measured cystatin C (cyst C) to estimate GFR. Children with decreased cyst C eGFR also underwent iohexol clearance examination. We measured urine-albumin/creatinine ratio, blood pressure (BP) and kidney volume on magnetic resonance imaging. Fibroblast growth factor 23 (FGF 23) levels in plasma were assessed by enzyme-linked immunosorbent assay (ELISA). Outcomes were compared between children with and without a history of neonatal AKI. Results: Forty-seven children participated in the assessment. Two children (2/42) had decreased cyst C eGFR, for one of whom iohexol clearance confirmed mildly decreased GFR. One child (1/43) had Kidney Disease Improving Global Outcomes (KDIGO) category A2 albuminuria, and three (3/45) had elevated office BP. Subsequent ambulatory 24-h BP measurement confirmed high normal BP in one case only. No child had hypertension. Kidney volume and FGF 23 levels were normal in all children. There was no difference in any of the parameters between children with and without a history of neonatal AKI. Conclusion: Renal sequelae were rare in early adolescence following hypothermia-treated HIE regardless of presence or absence of neonatal AKI. Graphical abstract: [Figure not available: see fulltext.].</p>}},
  author       = {{Robertsson Grossmann, Katarina and Vishnevskaya, Liya and Diaz Ruiz, Sandra and Kublickiene, Karolina and Bárány, Peter and Blennow, Mats and Chromek, Milan}},
  issn         = {{0931-041X}},
  keywords     = {{Acute kidney injury; Chronic kidney disease; Hypothermia treatment; Hypoxic-ischaemic encephalopathy; Long-term outcome; Perinatal asphyxia}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1205--1214}},
  publisher    = {{Springer}},
  series       = {{Pediatric Nephrology}},
  title        = {{Kidney outcomes in early adolescence following perinatal asphyxia and hypothermia-treated hypoxic-ischaemic encephalopathy}},
  url          = {{http://dx.doi.org/10.1007/s00467-022-05705-z}},
  doi          = {{10.1007/s00467-022-05705-z}},
  volume       = {{38}},
  year         = {{2023}},
}