Abstract：
OBJECTIVE: The objective of this study was to investigate the association between total bilirubin and acute kidney injury (AKI) in neonates admitted to neonatal intensive care units (NICU).
METHODS: All data utilized were extracted from Medical Information Mart for Intensive Care-III (MIMIC-III) in this retrospective cohort study. The primary outcome was the occurrence of AKI during hospitalization in the NICU, and the exposure was the initial measurement of total bilirubin levels within 24 h of neonatal admission to the NICU. The relationship between serum total bilirubin and AKI was evaluated by employing univariate and multivariate logistic regression models. Additionally, subgroup analyses were conducted based on birth weight, sepsis, and mechanical ventilation.
RESULTS: This retrospective cohort study included a population of 1,726 neonates, and 95 neonates developed AKI. Total bilirubin, as a continuous variable, was linked with decreased AKI risk among neonates admitted to the NICU [odds ratio (OR) = 0.77, 95% confidence interval (CI): 0.64-0.92]. Similarly, when total bilirubin levels were categorized by tertiles, tertiles 3 showed a significant association with decreased AKI risk (OR = 0.39, 95%CI: 0.19-0.83). The relationship of total bilirubin level and AKI was also existent among neonates admitted to the NICU who were underweight, had not sepsis, and received mechanical ventilation.
CONCLUSIONS: Total bilirubin level may be a protective factor for the risk of developing AKI.
METHODS: All data utilized were extracted from Medical Information Mart for Intensive Care-III (MIMIC-III) in this retrospective cohort study. The primary outcome was the occurrence of AKI during hospitalization in the NICU, and the exposure was the initial measurement of total bilirubin levels within 24 h of neonatal admission to the NICU. The relationship between serum total bilirubin and AKI was evaluated by employing univariate and multivariate logistic regression models. Additionally, subgroup analyses were conducted based on birth weight, sepsis, and mechanical ventilation.
RESULTS: This retrospective cohort study included a population of 1,726 neonates, and 95 neonates developed AKI. Total bilirubin, as a continuous variable, was linked with decreased AKI risk among neonates admitted to the NICU [odds ratio (OR) = 0.77, 95% confidence interval (CI): 0.64-0.92]. Similarly, when total bilirubin levels were categorized by tertiles, tertiles 3 showed a significant association with decreased AKI risk (OR = 0.39, 95%CI: 0.19-0.83). The relationship of total bilirubin level and AKI was also existent among neonates admitted to the NICU who were underweight, had not sepsis, and received mechanical ventilation.
CONCLUSIONS: Total bilirubin level may be a protective factor for the risk of developing AKI.
摘要：
目的：本研究的目的是探讨新生儿重症监护病房（NICU）新生儿总胆红素与急性肾损伤（AKI）的关系。
方法：在这项回顾性队列研究中，利用的所有数据均来自重症监护医学信息集市III（MIMIC-III）。主要结局是NICU住院期间AKI的发生，暴露量是新生儿入住NICU后24小时内总胆红素水平的初始测量值。采用单因素和多因素logistic回归模型评价血清总胆红素与AKI的关系。此外,亚组分析基于出生体重，脓毒症,机械通气。
结果：这项回顾性队列研究包括1,726名新生儿，95例新生儿发生AKI。总胆红素,作为连续变量，在入住NICU的新生儿中,与AKI风险降低相关[比值比(OR)=0.77,95%置信区间(CI):0.64-0.92].同样，当总胆红素水平按三元组分类时，三元指数3显示与AKI风险降低显著相关(OR=0.39,95CI:0.19-0.83).总胆红素水平与AKI的关系也存在于体重不足的新生儿中，没有败血症,并接受了机械通气。
结论：总胆红素水平可能是发生AKI的保护因素。
方法：在这项回顾性队列研究中，利用的所有数据均来自重症监护医学信息集市III（MIMIC-III）。主要结局是NICU住院期间AKI的发生，暴露量是新生儿入住NICU后24小时内总胆红素水平的初始测量值。采用单因素和多因素logistic回归模型评价血清总胆红素与AKI的关系。此外,亚组分析基于出生体重，脓毒症,机械通气。
结果：这项回顾性队列研究包括1,726名新生儿，95例新生儿发生AKI。总胆红素,作为连续变量，在入住NICU的新生儿中,与AKI风险降低相关[比值比(OR)=0.77,95%置信区间(CI):0.64-0.92].同样，当总胆红素水平按三元组分类时，三元指数3显示与AKI风险降低显著相关(OR=0.39,95CI:0.19-0.83).总胆红素水平与AKI的关系也存在于体重不足的新生儿中，没有败血症,并接受了机械通气。
结论：总胆红素水平可能是发生AKI的保护因素。
