Clinical profile of neonates with acute renal injury in neonatal intensive care unit at GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat, India

Abstract

Background: Acute kidney injury (AKI) is defined as an acute deterioration in ability of the kidneys to maintain homeostasis of body fluids and electrolytes leading to retention of wasted and toxic metabolic end products. It is fairly common in newborn population and is a major contributor of neonatal mortality and morbidity. The aim was to study the incidence of renal failure in high risk neonates and risk factors for renal failure.Methods: A prospective observational study was done to evaluate renal profile in high risk neonates admitted to neonatal intensive care unit, GMERS Medical College and General Hospital, Gotri, Vadodara, Gujarat, India over a 1-year period. nRifle criteria was used for classification of acute kidney injury.Results: The incidence of AKI in high risk newborns admitted in this study was 52 (37.14%). The male to female ratio in current study was 2.46:1. Majority of neonates with AKI were out born 44 (84.6%). The incidence of AKI was higher in term newborns. Mean weight in AKI group was 2048 grams. The highest incidence of AKI was found in AFD newborns (57.69%). nRifle criteria was used to diagnose AKI in this study. Out of 52 neonates who had AKI, 27 (51.9%) were in risk category, 21 (40.4%) were in injury group and 4 (7.7%) were in failure group. Mortality in these groups were 5 (18.51%), 7 (33.33%) and 3 (75%) respectively. Highest correlation of risk factors for AKI was found with birth asphyxia 18 (34.9%) followed by sepsis 12 (23.1%) and shock 15 (28.5%). 29 (55.76%) neonates had non oliguric AKI. 28 (53.8%) neonates with AKI developed dyselectrolytemia.Conclusions: Early recognition and management of risk factors can help in reducing the occurrence and improve outcomes in them.

Clinical profile and outcome of acute kidney injury in preterm neonates in a level three neonatal intensive care unit

“…14 In a retrospective study done by Bolat et al including 162 babies with AKI, it was found that 38% of the neonates had respiratory distress syndrome. 15 In a prospective study done by Timovska et al it was found that amongst 50 babies with AKI, 24% had respiratory distress syndrome. 10 In a case control study done by El Badawy et al including 41 neonates, it was found that 70.5% of the babies had exposure to nephrotoxic drugs.…”

Aetiology and mortality predictors in critically ill neonates with acute kidney injury at a tertiary health centre: a prospective observational study

“…Due to lack of precise definition, the real prevalence of AKI in the neonate is unknown, and varies from 1.5% to 56%, associated with higher mortality and consuming more expenses due to long hospital stay [4][5][6][7] . In India, AKI incidence ranges from 4.2% to 37.1%, with a 60% mortality in neonates [8][9][10] . Presence of shock, sepsis, use of mechanical ventilation and need of renal replacement therapy were associated with higher mortality in neonates with AKI [11][12][13][14][15] .…”