Charlton JR, et al. - Researchers assessed the risk factors and outcomes of neonatal AKI in the first postnatal week in the international retrospective observational cohort study, Assessment of Worldwide AKI Epidemiology in Neonates (AWAKEN). Participants were neonates admitted to a neonatal intensive care unit who received at least 48 hours of intravenous fluids. Findings revealed a common occurrence of AKI in the first postnatal week; early AKI developed in 21% (449 of 2110). Higher risk of death and longer duration of hospitalization were observed in relation to early AKI, adjusting for neonatal and maternal factors along with medication exposures. Outborn delivery; resuscitation with epinephrine; admission diagnosis of hyperbilirubinemia, inborn errors of metabolism, or surgical need; frequent kidney function surveillance; and admission to a children’s hospital were all found to be related to a higher risk of AKI. Factors associated with a lower risk included multiple gestations, cesarean section, and exposures to antimicrobials, methylxanthines, diuretics, and vasopressors.