AUTHOR=Askenazi David Joseph 

TITLE=AWAKEN-Ing a New Frontier in Neonatal Nephrology

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00021

DOI=10.3389/fped.2020.00021

ISSN=2296-2360

ABSTRACT=<p>In 2013, literature about the epidemiology of neonatal acute kidney injury (AKI) was limited to primarily retrospective, single center studies that suggested that AKI was common and that those with AKI had higher rates of mortality. We developed a 24-center retrospective cohort of neonates admitted to the NICU between January 1 and March 31, 2014. Analysis of the Assessment of Worldwide Acute Kidney Epidemiology in Neonates (AWAKEN) cohort, has allowed us to describe the prevalence, risk factors and impact of neonatal AKI for different gestational age cohorts. The ample sample size allows us to provide convincing data to show that those with AKI have an increase <italic>independent</italic> higher odds of death and prolonged hospitalization time (<xref ref-type="bibr" rid="B1">1</xref>). This data mirrors similar studies in pediatric (<xref ref-type="bibr" rid="B2">2</xref>) and adult (<xref ref-type="bibr" rid="B3">3</xref>) critically ill populations which collectively suggest that patients do not just die with AKI, but instead, AKI is directly linked to hard clinical outcomes. This study has allowed us to answer multiple other questions in the field which has expanded our understanding of the risk factors, complications, impact of fluid overload, the definition of neonatal AKI and suggests interventions for improving outcomes. Furthermore, this project brought together neonatologist and nephrologist within and across centers. Finally, the AWAKEN project has enabled us to build relationships and infrastructure that has launched the Neonatal Kidney Collaborative <ext-link ext-link-type="uri" xlink:href="http://babykidney.org/" xmlns:xlink="http://www.w3.org/1999/xlink">http://babykidney.org/</ext-link> on its way to accomplish its stated mission to improve the health of newborns with or at risk for kidney disease through multidisciplinary collaborative research, advocacy, and education.</p>