Magnitude and associated factors of acute kidney injury among preterm neonates admitted to public hospitals in Bahir Dar city, Ethiopia 2022: cross-sectional study

Abstract

Background Acute kidney injury is an independent risk factor for morbidity and mortality in critically ill neonates. Although the magnitude of preterm neonates is high and a major risk for acute kidney injury, there is a paucity of information regarding the magnitude and associated factors of acute kidney injury among preterm neonates in the study area. Therefore, the aim of this study was to assess magnitude and associated factors of acute kidney injury among preterm neonates admitted to public hospitals in Bahir Dar city, Ethiopia, 2022. Methods An institutional-based cross-sectional study was conducted among 423 preterm neonates admitted to public hospitals in Bahir Dar city from May 27 to June 27, 2022. Data were entered into Epi Data Version 4.6.0.2 transferred to Statistical Package and Service Solution version 26 for analysis. Descriptive and inferential statistics were employed. A binary logistic regression analysis was done to identify factors associated with acute kidney injury. Model fitness was checked through Hosmer-Lemeshow goodness of fit test. Variables with a p-value < 0.05 were considered as statistically significant in the multiple binary logistic regression analysis. Result Out of 423 eligible, 416 neonatal charts were reviewed with a response rate of 98.3%.This study revealed that the magnitude of acute kidney injury was 18.27% (95% CI = 15–22). Very low birth weight (AOR = 3.26; 95% CI = 1.18–9.05), perinatal asphyxia (AOR = 2.84; 95%CI = 1.55–5.19), dehydration (AOR = 2.30; 95%CI = 1.29–4.09), chest compression (AOR = 3.79; 95%CI = 1.97–7.13), and pregnancy-induced hypertension (AOR = 2.17; 95%CI = 1.20–3.93) were factors significantly associated with the development of neonatal acute kidney injury. Conclusion Almost one in five admitted preterm neonates developed acute kidney injury. The odds of acute kidney injury were high among neonates who were very low birth weight, perinataly asphyxiated, dehydrated, recipients of chest compression, and born to pregnancy-induced hypertensive mothers. Therefore, clinicians have to be extremely cautious and actively monitor renal function in those neonatal population in order to detect and treat acute kidney injury as early as possible.

Incidence and predictors of acute kidney injury among asphyxiated neonates in comprehensive specialized hospitals, northwest Ethiopia, 2023

“…In contrast to the aforementioned studies, the present study was higher than studies conducted in Kenya at 11.7% 30 , Egypt at 29.2 31 Tanzania at 31.5% 32 India at 4.24% 33 , Ethiopia at 18.27% 34 , Macedonia 6.5 35 in Pakistan 37.6 36 , in India 25.70% 37 in turkey 8.4% 38 , It seems that the marked difference observed in the previous studies could be attributed to the criteria used to diagnose and include subjects in the studies. Specifically, these studies included all admitted neonates, particularly those who were critically ill When studying acute kidney injury (AKI) in neonates, the inclusion of a broader range of critically ill neonates may lead to differences in the observed incidence and characteristics of AKI compared to studies that focus on specific subgroups or exclude less severe cases.…”

“…Being neonates delivered via cesarean section were 64% times less likely to develop AKI as compared to their counterparts. these findings were supported by Ethiopia 34 in the USA 42 . The possible justification for newborns delivered by cesarean section is the safest way to give birth 43 .…”