{"doi":"10.17615/22ja-zr64","title":"Association between Nephrotoxic Drug Combinations and Acute Kidney Injury in the Neonatal Intensive Care Unit","abstract":"Objective: To determine the incidence of acute kidney injury (AKI) in infants exposed to nephrotoxic drug combinations admitted to 268 neonatal intensive care units managed by the Pediatrix Medical Group. Study design: We included infants born at 22-36 weeks gestational age, ≤120 days postnatal age, exposed to nephrotoxic drug combinations, with serum creatinine measurements available, and discharged between 2007 and 2016. To identify risk factors associated with a serum creatinine definition of AKI based on the Kidney Disease: Improving Global Outcomes criteria, we performed multivariable logistic and Cox regression adjusting for gestational age, sex, birth weight, postnatal age, race/ethnicity, sepsis, respiratory distress syndrome, baseline serum creatinine, and duration of combination drug exposure. The adjusted odds of AKI were determined relative to gentamicin + indomethacin for the following nephrotoxic drug combinations: chlorothiazide + ibuprofen; chlorothiazide + indomethacin; furosemide + gentamicin; furosemide + ibuprofen; furosemide + tobramycin; ibuprofen + spironolactone; and vancomycin + piperacillin-tazobactam. Results: Among 8286 included infants, 1384 (17%) experienced AKI. On multivariable analysis, sepsis, lower baseline creatinine, and duration of combination therapy were associated with increased odds of AKI. Furosemide + tobramycin and vancomycin + piperacillin-tazobactam were associated with a decreased risk of AKI relative to gentamicin + indomethacin in both the multivariable and Cox regression models. Conclusions: In this cohort, infants receiving longer durations of nephrotoxic combination therapy had an increased odds of developing AKI.","journal":"UNC Libraries","year":2021,"id":229867,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.907,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":835003,"name":"Deniau Benjamin","orcid":null,"position":1,"is_corresponding":false},{"id":592575,"name":"D. Gonzalez","orcid":null,"position":2,"is_corresponding":false},{"id":835004,"name":"Y. Liao","orcid":null,"position":3,"is_corresponding":false},{"id":835005,"name":"K. Sanderson","orcid":null,"position":4,"is_corresponding":false},{"id":835006,"name":"R.H. Clark","orcid":null,"position":5,"is_corresponding":false},{"id":326441,"name":"Cameron J. McKinzie","orcid":"0000-0003-1401-5628","position":6,"is_corresponding":false},{"id":835007,"name":"R.G. Greenberg","orcid":null,"position":7,"is_corresponding":false},{"id":835008,"name":"A. McCallister","orcid":null,"position":8,"is_corresponding":false},{"id":835009,"name":"W. Jackson","orcid":null,"position":9,"is_corresponding":false},{"id":835010,"name":"S.N. Salerno","orcid":null,"position":10,"is_corresponding":false},{"id":835002,"name":"M.M. Laughon","orcid":null,"position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-18T23:55:01.675482Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}