WIP 155 - Relationship Between Imaging Findings of Hypoxic Ischemic Encephalopathy and Severity of Acute Kidney Injury

Poster Number: WIP 155
Publication Number: WIP 155.2382

Background: Prior to therapeutic hypothermia becoming standard of care for neonatal Hypoxic Ischemic Encephalopathy (HIE), there were well-documented correlations between acute kidney injury (AKI) and normothermic HIE severity (47%-72%) with worse long term neurodevelopmental outcomes. Early studies investigated the impact therapeutic hypothermia on AKI severity and found that the known association of AKI and HIE severity persisted regardless of initiation of standard hypothermia protocols. Further, AKI in HIE neonates carries its own morbidity, with increased mean length of stay and days on mechanical ventilation compared to HIE infants without AKI. Another study showed children with AKI are more likely to have an abnormal brain MRI after therapeutic hypothermia, though, severity of HIE and MRI changes were not correlated. This study only focused on structural MRI abnormalities, however, and AKI may be a different marker for severity of the hypoxic ischemic event.

There is no study to date which correlates resistive indices on head ultrasound and choline peaks on MR-Spectroscopy (a marker of membrane damage and turnover) with occurrence and severity of AKI and renal blood flow indices. These associations need to be better parsed out with physiologic data from cerebral/renal ultrasound in HIE neonates.

Objective: To build on previous studies showing a correlation between AKI and HIE, we are performing a retrospective chart review examining the relationship between AKI and HIE parameters to determine whether there is a physiologic correlation based on clinical and imaging findings (MRI, Ultrasound, MRS).

Design/Methods: This is an IRB-approved retrospective chart review from 2012-2022 at the Medical University of South Carolina. Demographic data will be collected in addition to serum creatinine (to measure severity of AKI), urine output, doppler blood flow resistive indices in kidney and cerebral vessels, MRS ratios of N-Acetylaspartate, choline, creatine, and glutathione, and MRI findings.