Frequency of various causes of acute kidney injury in neonates in a tertiary care hospital neonatal intensive care.

Abstract

Objective: To determine the frequency of causes of acute kidney injury in neonatal. Study Design: Cross Sectional study. Setting: Neonatology Ward, Saidu Teaching Hospital. Period: July 2020 to June 2021. Material & Methods: A total of 257 neonates were selected having AKI and included in the study. Various causes and risk factors for AKI were assessed and patients were followed till the outcome. Results: A total of 257 patients having AKI were included and data was collected. Of the total selected newborns gender distribution was 57.97% (149/257) males and female were 42.02% (108/257). Mean age was 5.1 ± 4.6 days. 73.15% babies were delivered at term gestation and 26.84% were delivered preterm. 90.27 % babies were delivered through normal vaginal delivery and 9.7% were delivered through caesarean section. Among the total 257 included babies 27.62% were having history of hypoxic ischemic encephalopathy and 45.52% were diagnosed as sepsis on positive blood culture or septic screening. Oliguria was present in only 38.13% of the babies and urine output was normal in 61.86%. 95.71% babies were not having renal malformations. Renal profile of the babies showed with mean serum creatinine of 2.57 mg/dl. Mean sodium level was 139.16 mg/dl and mean potassium level was 3.59 mg/dl. 26.45% of the total patients died and the mortality rate was 29% in patient having sepsis as compared to 25% of patient having hypoxic ischemic encephalopathy. Conclusion: AKI in NICU is very common and needs a proper evaluation and management strategies. Neonatologist should be aware of the various causes of AKI and should be able to diagnose it on time. In neonates having AKI, oliguria is not that much common therefore it is recommended not to wait for a decrease urine output but to screen all the high risk neonates for AKI with serum creatinine level. Mortality in neonates due to AKI was high specifically in male gender having sepsis, HIE or oliguria.