Eur J Pediatr. 2026 Jan 5;185(1):53. doi: 10.1007/s00431-025-06675-8.
ABSTRACT
Acute kidney injury (AKI) in preterm neonates is a serious pathology linked to the neonatal mortality rate. Since there is no comprehensive systematic review and meta-analysis in this regard, this study aimed to investigate the global prevalence of AKI in preterm neonates. A comprehensive literature search was conducted using MeSH-based keywords across multiple databases (by August 22, 2025). Eligibility criteria were considered via the PRISMA guideline, and quality assessment was applied using the STROBE checklist. Following data extraction, meta-analysis was applied using CMA (v.3) software. Heterogeneity was assessed using the I2 test, publication bias was evaluated via the Egger test and funnel plots, and subgrouping and sensitivity analyses were considered to ensure result robustness. Data were presented as 95% CI, and p < 0.05 was considered a significant level. Following the assessment of 1032 records, 26 eligible investigations with a total number of 1,328,711 preterm neonates admitted to NICU were selected. 21,568 cases were diagnosed with AKI; thus, the global prevalence of AKI in preterm neonates admitted to NICU was 17.8% (95% CI: 8.6%-33.2%, I2 = 99.8%, p < 0.001). Subgroup analyses demonstrated regional variations in prevalence, including 18.3% in Africa, 18.5% in America, 15.2% in Asia, and 20.1% in Europe. Meta-regression found no significant temporal trend in AKI prevalence over the study years.
CONCLUSION: According to the findings, it is essential to monitor the renal health status in preterm infants admitted to the NICU. Failure to undergo preterm screening can lead to long-term kidney issues in adulthood.
WHAT IS KNOWN: • AKI is a major complication among preterm neonates and contributes to neonatal morbidity and mortality. • Diagnosis of AKI in neonates is challenging due to varying definitions and inconsistent use of biomarkers.
WHAT IS NEW: • This study included over 1.3 million preterm neonates, establishing a pooled AKI prevalence of 17.8%. • Africa (15.2%) and Europe (20.1%) comprise the lowest and the highest rates of AKI, respectively.
PMID:41489685 | DOI:10.1007/s00431-025-06675-8
