Harer, MatthewZapata, HenryTodurkar, NamrataFavel, KristenGriffin, RussellStarr, MichelleCharlton, JenniferMcAdams, RyanAskenazi, DavidKulkarni, TapasMenon, ShinaMammen, Cherry2024-09-202024-09-202024-07-19Harer M, Zapata H, Todurkar N, et al. Association of delayed cord clamping with acute kidney injury and two-year kidney outcomes in extremely premature neonates: a secondary analysis of the Preterm Erythropoietin Neuroprotection Trial (PENUT). Preprint. Res Sq. 2024;rs.3.rs-4631779. Published 2024 Jul 19. doi:10.21203/rs.3.rs-4631779/v1https://hdl.handle.net/1805/43458Background: Delayed cord clamping (DCC) occurs in most preterm births. Objective: Evaluate the association of DCC with acute kidney injury (AKI) and two-year kidney outcomes. Methods: Secondary analysis of the Preterm Erythropoietin Neuroprotection Trial of neonates born 240/7 to 276/7 weeks' gestation. AKI and two year kidney outcomes were compared in neonates with DCC (≥30 seconds after delivery) to those with early cord clamping (ECC) (<30 seconds after delivery). Results: The incidence and severity of AKI did not differ between the DCC and ECC groups (aOR 1.17 [95%CI 0.76-1.80]). At two years corrected age, DCC was associated with a 4.5-fold times increased adjusted odds of eGFR <90 mL/min/1.73m2. No significant associations were noted between DCC and albuminuria or elevated BP. Conclusions: DCC was not associated with decreased neonatal AKI, but was associated with higher adjusted odds of eGFR <90 mL/min/1.73m2 at two years.en-USAttribution 4.0 InternationalAcute renal failureChronic kidney diseaseDelayed cord clampingGlomerular filtration rateHypertensionLong-term outcomesPrematurityArticle