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Am J Perinatol
DOI: 10.1055/a-2798-8294
Original Article

Assessment of Kidney function and acute kidney injury following Transcatheter PDA Closure in preterm infants

Authors

  • Dipen Vyas

    1   Pediatrics (Neonatology), University of Mississippi University Hospital, Jackson, United States (Ringgold ID: RIN21693)

  • Timothy Martin

    2   School of Medicine, The University of Mississippi Medical Center, Jackson, United States (Ringgold ID: RIN21693)

  • Aditya Patel

    3   Pediatrics (Neonatology), The University of Mississippi Medical Center Department of Pediatrics, Jackson, United States (Ringgold ID: RIN167475)

  • Andrew Micheal South

    4   Pediatrics/nephrology, Wake Forest School of Medicine, Winston-Salem, United States (Ringgold ID: RIN12279)

  • Parvesh Mohan Garg

    5   Pediatrics (Neonatology), Wake Forest University School of Medicine, Winston-Salem, United States (Ringgold ID: RIN12279)

Supported by: NIH-National Heart, Lung, and Blood Institute K23HL148394
Supported by: National Institute of General Medical Sciences of the National Institutes of Health 5U54GM115428
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Objective: Transcatheter Patent Ductus Arteriosus closure (TCPC) has been increasingly used in preterm infants. Hemodynamically significant patent ductus arteriosus (hsPDA) owing to ductal steal and changes in kidney perfusion is associated with the risk of acute kidney injury (AKI) and changes in kidney function. There is limited evidence describing changes in kidney function following TCPC and the factors that affect these changes. We conducted this study with the aim of reviewing the prevalence of AKI and changes in kidney function following TCPC in preterm infants. Methods: A single-center, retrospective cohort study was conducted to collect data from January 1, 2017, to February 29, 2024. Preterm infants born <29 weeks of gestational age (GA) receiving TCPC were included in the study. The primary outcome was AKI prevalence and kidney function following TCPC. AKI was defined as per the modified neonatal Kidney Disease: Improving Global Outcomes (KDIGO) criteria using serum creatinine (SCr) and urine output. Results: Eighty-nine infants fulfilled inclusion criteria. Included infants predominantly had female sex [50 (59.7%)], had median GA of 25w (IQR 24-27), and median birth weight of 700g (IQR 600–863). AKI developed in five infants (5.6%) following TCPC using SCr criteria. Four infants (4.5%) had stage 1 and one (1.1%) had stage 2 AKI. Overall, 14% reduction in SCr levels was seen following TCPC [median pre-TCPC 0.28mg/dL (IQR 0.21-0.35), median 5-7d post-TCPC 0.24mg/dL (IQR 0.18-0.29), p<0.001]. Infants who developed AKI had an initial rise in SCr followed by 37% reduction by 5-7d [pre-TCPC 0.41mg/dL (IQR 0.27-0.51); median 24h post 0.57mg/dL (IQR 0.29-1.22); 5-7d post 0.26mg/dL (IQR 0.19-0.67), p 0.07]. Conclusion: In preterm infants undergoing TCPC, a small percentage of infants developed mild AKI, which improved quickly within one week post-TCPC. Overall, there was a significant and persistent improvement in kidney function following TCPC.



Publication History

Received: 14 November 2025

Accepted after revision: 27 January 2026

Accepted Manuscript online:
29 January 2026

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