Browsing by Author "Lieberman, Joshua"

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    The Impact of Increased Awareness of Acute Kidney Injury in the Neonatal Intensive Care Unit on Acute Kidney Injury Incidence and Reporting: Results of a Retrospective Cohort Study
    (Springer Nature, 2020-09) Starr, Michelle C.; Kula, Alexander; Lieberman, Joshua; Menon, Shina; Perkins, Anthony J.; Lam, Teresa; Chabra, Shilpi; Hingorani, Sangeeta; Pediatrics, School of Medicine
    Objective: To evaluate the impact of nephrology integration in the NICU on acute kidney injury (AKI) incidence, provider reporting, and nephrology referral. Study design: Cohort study in a single-center NICU from January 2012 to December 2017 (n = 1464). We assessed the impact of clinical practice changes including neonatal-nephrology rounds on the incidence of AKI. Results: AKI occurred in 318 neonates (22%). AKI occurred less frequently in those admitted after clinical practice changes (P < 0.001). After multivariable adjustment, clinical practice changes were associated with reduced odds of AKI (adjusted odds ratio, 0.31; 95% CI 0.22-0.44, P < 0.001). Provider reporting of AKI improved (P < 0.001) and more neonates were referred for nephrology follow-up (P < 0.001). Conclusions: Increased nephrology integration in the NICU was associated with decreased AKI incidence. While recognition of AKI improved, AKI remained poorly reported and nephrology AKI follow-up did not routinely occur. This study supports the importance of increased nephrology involvement in the NICU.