Acute kidney injury associated with increased costs in the neonatal intensive care unit: analysis of Pediatric Health Information System database

J Perinatol. 2025 Jan;45(1):94-100. doi: 10.1038/s41372-024-02193-x. Epub 2024 Dec 5.

Abstract

Objective: Compare neonatal intensive care unit hospitalization costs between neonates with and without AKI; identify predictors of AKI-associated costs. We hypothesized neonates with AKI would amass more costs than those without AKI.

Study design: Retrospective, multicenter cohort study of surviving neonates cared for 2015-2021 in Pediatric Health Information System database. The primary outcome was estimated hospitalization costs.

Results: Data from 304,725 neonates were evaluated, 8774 (3%) with AKI and 295,951 (97%) without AKI. Neonates with AKI had $58,807 greater adjusted costs than those without AKI. AKI-associated costs were most strongly driven by Feudtner Pediatric Complex Chronic Conditions Classifications (cardiovascaular, congenital/genetic, gastrointestinal, medical technology) and gestational age. Adjusted costs decreased with increasing gestational age, regardless of AKI status.

Conclusions: AKI is independently associated with increased hospital costs. Knowledge of these drivers can help in identifying high-value practices for cost mitigation strategies.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Kidney Injury* / economics
  • Acute Kidney Injury* / therapy
  • Databases, Factual*
  • Female
  • Gestational Age
  • Health Information Systems / economics
  • Hospital Costs* / statistics & numerical data
  • Hospitalization / economics
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal* / economics
  • Male
  • Retrospective Studies
  • United States