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Caffeine Found to Reduce Acute Kidney Injury Incidence in Neonates

Preterm neonates who are exposed to caffeine within the first seven days after birth showed reduced incidence and severity of acute kidney injuries than neonates who didn't, according to findings from the Neonatal Kidney Collaborative's Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates study, published in JAMA Pediatrics. David Askenazi, MD, a professor in the University of Alabama at Birmingham's (UAB) department of pediatrics and director of the UAB and Children's of Alabama's Pediatric and Infant Center for Acute Nephrology, is the study's coauthor and the chair of the Neonatal Kidney Collaborative.

"We have found that neonatal acute kidney injury occurs in one of every four preterm neonates and has an association with increased hospital stays, medical expenditures, morbidity, and mortality," Askenazi says. "This research provides hope that interventions—in this case, caffeine administration—can help neonates who are at an increased risk of acute kidney injury."

The multiple-center, cohort study evaluated 675 preterm neonates born at less than 33 weeks' gestation and found that 11.2% of neonates who received caffeine developed acute kidney injury vs 31.6% of those who didn't get caffeine.

In neonatal ICUs across the country, neonates are given caffeine to stimulate them and allow their underdeveloped lungs and brains to continue to breathe; caffeine has been used for years to prevent episodes of apnea, intermittent hypoxia, and need for intubation. This study suggests caffeine also may help the kidneys.

"The study's findings certainly have potential to change clinical treatment and timing of caffeine provision, which may ultimately reduce the morbidity and mortality associated with neonatal kidney development and disease," Askenazi says.