Association of patent ductus arteriosus treatment in extremely low gestational age neonates with two year kidney outcomes: a secondary analysis of the preterm erythropoietin neuroprotection trial (PENUT)

作者：Paige E. Condit, Ronnie Guillet, Dinushan C. Kaluarachchi, Russell Griffin, Shina Menon, David J. Askenazi, Matthew W. Harer · 发表于：BMC Nephrology · 年份：2025 · DOI：10.1186/s12882-025-04065-8 · 被引用次数：5 · 研究领域：Cardiovascular Conditions and Treatments、Renal and Vascular Pathologies、Congenital Heart Disease Studies

BACKGROUND: Management of patent ductus arteriosus (PDA) is variable and includes expectant, medical, and procedural options. Both the hemodynamic effects of a PDA and its treatment put neonates at risk for acute kidney injury (AKI). Little is known about how different management approaches to a PDA, either conservative management or active management and either medical or surgical treatment, in preterm neonates impact kidney function over the longer term. The objective of this study is to evaluate rates of kidney dysfunction at two years of age in extremely low gestational age neonates (ELGANs) with treated compared to untreated PDAs. METHODS: , systolic or diastolic blood pressures (SBP or DBP) > 90th percentile, or proteinuria measured by albumin to creatinine ratio (ACR) > 30 mg/g. Between-group, variables were compared using chi-square or t-test statistics. General estimating equations and multivariable logistic regression was used to evaluate the association with outcomes. RESULTS: Of 780 ELGANs, 261 (43%) were treated for PDA. Of those treated, 168 (64.4%) received pharmacologic treatment, 12 (4.6%) received surgical treatment, 57 (21.8%) received both, and 24 (9.2%) were listed as having a treated PDA without specification of management. After adjusting for confounding factors, those actively treated for a PDA were less likely to have SBP > 90th percentile at two years (29.5% treated vs. 34.3% control, adjusted OR 0.59, CI 0.36-0.99). The adjusted odds-ratios for diff...