{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:15:05Z","timestamp":1753892105595,"version":"3.41.2"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Renal autoregulation, hemodynamic response, and endothelial dysfunction play significant roles in acute kidney injury (AKI) during perinatal asphyxia. A third mechanism of autoregulation, involving very low-frequency oscillations, has been described. This study aimed to evaluate the relationship between the power of the very low-frequency component of the Fast Fourier Transform (FFT) and AKI during therapeutic hypothermia (TH) treatment in neonates with perinatal asphyxia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>A retrospective longitudinal study was conducted on neonates with moderate and severe perinatal asphyxia. AKI was defined as a decrease of less than 33% in the serum creatinine level by day 3. The power of the very low-frequency component in the FFT was assessed by analyzing renal oxygen saturation using near-infrared spectroscopy (NIRS), focusing on a frequency band of approximately 0.01\u2005Hz. Bivariate analyses were performed to explore the association between the power of the very-low-frequency component and AKI. The predictive ability of this component for AKI was evaluated using a receiver operating characteristic (ROC) curve. Additionally, a generalized estimating equation (GEE) was developed to investigate whether changes in the power of the very-low-frequency component during treatment differed according to the presence of AKI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 91 patients were included in the study, of whom 15 (16.5%) developed AKI. Neonates with AKI exhibited a significantly lower power of the very low-frequency component on the second day of treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). This component demonstrated good predictive ability for AKI (ROC curve 0.77, 95% CI 0.63\u20130.90).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among neonates with perinatal asphyxia who developed AKI, a lower power of the very-low-frequency component in FFT (approximately 0.01\u2005Hz) was observed on the second day of therapeutic hypothermia. This finding suggests that alterations in very-low-frequency oscillations may reflect endothelial dysfunction and contribute to the development of AKI, warranting further investigation in larger cohorts.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1490321","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T07:20:14Z","timestamp":1737357614000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of the very low frequencies of the renal oxygen saturation signal in acute kidney injury in newborns with perinatal asphyxia"],"prefix":"10.3389","volume":"13","author":[{"given":"Daniel","family":"Botero-Rosas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Agudelo-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Troncoso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria C.","family":"G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Tuta-Quintero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"347","DOI":"10.3390\/biomedicines10020347","article-title":"Pathophysiology of perinatal asphyxia in humans and animal models","volume":"10","author":"Mota-Rojas","year":"2022","journal-title":"Biomedicines"},{"key":"B2","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/S2352-4642(21)00311-4","article-title":"Global, regional, and national causes of under-5 mortality in 2000\u201319: an updated systematic analysis with implications for the sustainable development goals","volume":"6","author":"Perin","year":"2022","journal-title":"Lancet Child Adolesc Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1016\/S0140-6736(17)30547-0","article-title":"Towards evidence-based resuscitation of the newborn infant","volume":"389","author":"Manley","year":"2017","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"280.e1","DOI":"10.1016\/j.anpede.2022.08.010","article-title":"Neonatal multiple organ failure after perinatal asphyxia","volume":"97","author":"Iribarren","year":"2022","journal-title":"Anales de Pediatr\u00eda (Engl Ed)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1016\/j.siny.2008.04.011","article-title":"Post-resuscitation strategies to avoid ongoing injury following intrapartum hypoxia\u2013ischemia","volume":"13","author":"Stola","year":"2008","journal-title":"Semin Fetal Neonatal Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.pedneo.2021.01.010","article-title":"Renal impairment following perinatal asphyxia","volume":"62","author":"Nishijima","year":"2021","journal-title":"Pediatr Neonatol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e0247403","DOI":"10.1371\/journal.pone.0247403","article-title":"Effect of therapeutic hypothermia on renal and myocardial function in asphyxiated (near) term neonates: a systematic review and meta-analysis","volume":"16","author":"van Wincoop","year":"2021","journal-title":"PLoS One"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.7863\/jum.2009.28.11.1471","article-title":"Changes in cerebral and visceral blood flow velocities in asphyxiated term neonates with hypoxic-ischemic encephalopathy","volume":"28","author":"Ilves","year":"2009","journal-title":"J Ultrasound Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1212\/WNL.0b013e31829bfe41","article-title":"Limited short-term prognostic utility of cerebral NIRS during neonatal therapeutic hypothermia","volume":"81","author":"Shellhaas","year":"2013","journal-title":"Neurology"},{"key":"B10","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1201\/9780367494018-25","article-title":"Hypoxic respiratory failure and the neonatal kidney. 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