Prolonged patent ductus arteriosus exposure and risk for late acute kidney injury in extremely preterm infants

OBJECTIVE: To study duration of hemodynamically significant patent ductus arteriosus (HPDA) exposure increases the risk of late acute kidney injury (AKI) and severity of AKI. STUDY DESIGN: This was a single-center retrospective cohort study. Included infants born between 22 and 28.6 weeks' gestation with >1 echocardiographic finding for HPDA were stratified by HPDA duration: 4-7 weeks, 8-11 weeks, and greater than 12 weeks. AKI was determined utilizing KDIGO AKI criteria. Logistic regression analysis was used to evaluate odds ratios of each HPDA exposure groups for any AKI and severe (stage 2 or 3) AKI. RESULTS: Among the 216 infants, 39(18%) developed AKI and 27(13%) developed severe AKI. Infants exposed to ≥12 weeks of HPDA exposure had a 3.96 (95% CI 1.32-11.87) higher odds of AKI, which was nonsignificant after adjustment for gestational age (aOR 2.37; 95% CI 0.72-7.78). CONCLUSION: Whether longer HPDA exposure increases risk for AKI development requires further investigation from trials of late PDA closure.