Association between Caffeine Citrate and Incidence of Acute Kidney Injury in Preterms

Background: As a result of prematurity, Acute kidney injury (AKI) occurs commonly in preterm neonates and is associated with increased morbidity and mortality. (AKI) is defined as a rapid, potentially reversible deterioration in renal functions sufficient to result in accumulation of nitrogenous wastes in the body.

Aim of the Study: the aim of this study was to determine whether preterm neonates who took caffeine citrate from the first day after birth were less likely to AKI within the first 7 days.

Patients and Methods: This case control study was conducted on 100 preterm neonates at Neonatal Intensive Care Units (NICUS), Pediatric Department, Tanta University with gestational age less than (30 weeks) were grouped into group A and B. Group A 50 preterm neonates who received caffeine citrate from the first day after birth with dose (20 mg/kg) loading dose, and (5 mg/kg/dose) every 24hrs of maintenance dose, given as slow intravenous infusion over twenty to thirty minutes for a week. Group B 50 preterm neonates who did not receive caffeine citrate.

Inclusion Criteria: all preterms <30 weeks admitted within first 24 hours after birth presented by respiratory distress according to Downes score.

Exclusion Criteria: newborns with congenital heart disease except non-significant PDA, neonatal mortality < 48 h of life, clinical signs suggest chromosomal anomalies, newborns with congenital renal anomalies.

Hematological Investigations: serum albumin, serum creatinine, blood urea.

Urinary Investigations: measuring urine output.

Results: There was a statistically significant difference between the two studied groups as regard serum creatinine in day (5,7) (p<0.001), urea in day 7 (p value <0.001), serum albumin in day (5,7) (p value ≤ 0.05), urine output in day (4,5,6,7) (p value ≤0.05), AKI incidence (p value <0.001).

Conclusion: Caffeine Citrate administration in preterm neonates from the first day of life for one week was associated with reduced occurrence and severity of AKI.