Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India

Abstract

AKI continues to be of clinical significance in neonatal intensive care. Further studies are needed to evaluate newer associations (like male gender and low APGAR scores).

Risk factors and mortality rate in premature babies with acute kidney injury

“…It has been noted that the incidence of AKI varies between 3.4% and 71% in critical neonates admitted to the NICU . In our study, the incidence of AKI in premature babies was 20%, which was consistent with the previous studies.…”

“…The mortality of nonoliguric AKI patients ranges from 4.5%‐40%, compared to 25%‐78% for patients with oligo‐anuric AKI . In our study, the mortality rate in the group of preterm babies with oliguric AKI was high (46.2%) (Table ) and we detected that AKI was associated with increased risk of mortality similar to other studies …”

“…Acute kidney injury is frequent in very preterm babies and is associated with increased risk of morbidity and mortality, after adjustment for confounders, although outcomes in very preterm babies have improved over the past few decades . To adjust for likely mixers, we developed a binary logistic regression model to study potential risk factors associated with AKI in premature babies.…”

“…Many possible risk factors such as low GA, low BW, low Apgar scores at 1 and 5 minutes, male gender, SGA, low cord pH, intubation at birth, mechanical ventilation, umbilical artery/venous catheters, lower mean arterial pressures, congenital heart disease, perinatal depression, assisted ventilation, oliguria/anuria, exposure to various medications such as blood pressure medications (pressor/inotropic support), antenatal corticosteroids, ampicillin, ceftazidime, cefotaxime, gentamicin, vancomycin, ibuprofen treatment, and multiorgan failure including disseminated intravascular coagulation (DIC) and shock for the development of AKI in neonates have been clarified . When compared to term babies, premature babies are at more risk of developing AKI because they are exposed to various risk factors including prenatal fetal distress and postnatal other multiple risk factors such as perinatal asphyxia, IVH, sepsis, PDA, RDS, bronchopulmonary dysplasia (BPD), NEC, intrauterine growth retardation, placental insufficiency, pneumothorax, and various medications.…”

“…When compared to term babies, premature babies are at more risk of developing AKI because they are exposed to various risk factors including prenatal fetal distress and postnatal other multiple risk factors such as perinatal asphyxia, IVH, sepsis, PDA, RDS, bronchopulmonary dysplasia (BPD), NEC, intrauterine growth retardation, placental insufficiency, pneumothorax, and various medications. Furthermore, postnatal progression of preterm babies is usually problematic owing to the call for cardiovascular support, hypotension, and hypoxia . Moreover, to be only prematurity is an independent risk factor for AKI because of an insufficient nephrogenesis and low nephron count .…”