Association of high-sensitivity C-reactive protein and anemia with acute kidney injury in neonates

Peiyao Zhang; Yuanyuan Tong; Deshan Yuan; Yixuan Li; Yu Jin; Liting Bai; Peng Gao; Wenting Wang; Jinxiao Hu; Xin Duan; Jinping Liu

doi:10.3389/fped.2022.882739

Association of high-sensitivity C-reactive protein and anemia with acute kidney injury in neonates

Front Pediatr. 2022 Nov 2:10:882739. doi: 10.3389/fped.2022.882739. eCollection 2022.

Authors

Peiyao Zhang^{1

2}, Yuanyuan Tong³, Deshan Yuan¹, Yixuan Li^{1

2}, Yu Jin^{1

2}, Liting Bai^{1

2}, Peng Gao^{1

2}, Wenting Wang^{1

2}, Jinxiao Hu², Xin Duan², Jinping Liu²

Affiliations

¹ State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Department of Cardiopulmonary Bypass, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Abstract

Background: The association of high-sensitivity C-reactive protein (hsCRP) and anemia with postoperative acute kidney injury (AKI) in neonates with congenital heart disease (CHD) is still unclear. The purpose of this study was to examine whether anemia-associated AKI is modulated by hsCRP in neonates.

Methods: This study included 253 consecutive neonatal patients who underwent CHD surgery in a national tertiary hospital. We investigated the association between postoperative AKI with baseline hsCRP, anemia, and their interaction by multivariable logistic regression analyses.

Results: The incidence of AKI was 24.1% in the entire cohort. After being adjusted for covariates, hsCRP level was negatively correlated with AKI (P < 0.01 for 1 mg/L threshold), whereas anemia emerged as an independent risk factor of AKI (P = 0.02). In addition, there was a significant interaction between anemia and hsCRP level (P = 0.01). In neonates with hsCRP < 1 mg/L, anemia was positively associated with AKI (P = 0.03). However, no significant association was found between anemia and AKI in the context of hsCRP ≥ 1 mg/L. Combination of anemia and hsCRP < 1 mg/L was independently correlated with the risk of AKI (P < 0.01), while concomitant anemia and hsCRP ≥ 1 mg/L or hsCRP < 1 mg/L combined with non-anemia was not.

Conclusions: In neonates with CHD, the risk of anemia-associated AKI may be modulated by hsCRP level. Attention should be paid to neonates with preoperative anemia and baseline hsCRP < 1 mg/L to reduce the risk of postoperative AKI.

Keywords: acute kidney injury; anemia; congenital heart disease; high-sensitivity C-reactive protein; neonates.