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Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit.

Publication ,  Journal Article
Sanderson, KR; Warady, B; Carey, W; Tolia, V; Boynton, MH; Benjamin, DK; Jackson, W; Laughon, M; Clark, RH; Greenberg, RG
Published in: J Pediatr
March 2022

OBJECTIVES: To identify risk factors associated with mortality for infants receiving dialysis in the neonatal intensive care unit (NICU). STUDY DESIGN: In this retrospective cohort study, we extracted data from the Pediatrix Clinical Data Warehouse on all infants who received dialysis in the NICU from 1999 to 2018. Using a Cox proportional hazards model with robust SEs we estimated the mortality hazard ratios associated with demographics, birth details, medical complications, and treatment exposures. RESULTS: We identified 273 infants who received dialysis. Median gestational age at birth was 35 weeks (interquartile values 33-37), median birth weight was 2570 g (2000-3084), 8% were small for gestational age, 41% white, and 72% male. Over one-half of the infants (59%) had a kidney anomaly; 71 (26%) infants died before NICU hospital discharge. Factors associated with increased risk of dying after dialysis initiation included lack of kidney anomalies, Black race, gestational age of <32 weeks, necrotizing enterocolitis, dialysis within 7 days of life, and receipt of paralytics or vasopressors (all P < .05). CONCLUSION: In this cohort of infants who received dialysis in the NICU over 2 decades, more than 70% of infants survived. The probability of death was greater among infants without a history of a kidney anomaly and those with risk factors consistent with greater severity of illness at dialysis initiation.

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Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

March 2022

Volume

242

Start / End Page

159 / 165

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Renal Dialysis
  • Pediatrics
  • Male
  • Intensive Care Units, Neonatal
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Infant Mortality
  • Infant
 

Citation

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ICMJE
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Sanderson, K. R., Warady, B., Carey, W., Tolia, V., Boynton, M. H., Benjamin, D. K., … Greenberg, R. G. (2022). Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit. J Pediatr, 242, 159–165. https://doi.org/10.1016/j.jpeds.2021.11.025
Sanderson, Keia R., Bradley Warady, William Carey, Veeral Tolia, Marcella H. Boynton, Daniel K. Benjamin, Wesley Jackson, Matthew Laughon, Reese H. Clark, and Rachel G. Greenberg. “Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit.J Pediatr 242 (March 2022): 159–65. https://doi.org/10.1016/j.jpeds.2021.11.025.
Sanderson KR, Warady B, Carey W, Tolia V, Boynton MH, Benjamin DK, et al. Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit. J Pediatr. 2022 Mar;242:159–65.
Sanderson, Keia R., et al. “Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit.J Pediatr, vol. 242, Mar. 2022, pp. 159–65. Pubmed, doi:10.1016/j.jpeds.2021.11.025.
Sanderson KR, Warady B, Carey W, Tolia V, Boynton MH, Benjamin DK, Jackson W, Laughon M, Clark RH, Greenberg RG. Mortality Risk Factors among Infants Receiving Dialysis in the Neonatal Intensive Care Unit. J Pediatr. 2022 Mar;242:159–165.
Journal cover image

Published In

J Pediatr

DOI

EISSN

1097-6833

Publication Date

March 2022

Volume

242

Start / End Page

159 / 165

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Renal Dialysis
  • Pediatrics
  • Male
  • Intensive Care Units, Neonatal
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Infant Mortality
  • Infant