Neonatal acute kidney injury in a tertiary center in a developing country

Vachvanichsanong, Prayong; McNeil, Edward; Dissaneevate, Supaporn; Dissaneewate, Pornsak; Chanvitan, Prasin; Janjindamai, Waricha

doi:10.1093/ndt/gfr477

Cited by 48 publications

(34 citation statements)

References 18 publications

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“…However, renal function improved in the majority of patients by appropriate antibiotic therapy and supportive management, with no residual renal impairment, which is in accordance with previous reports (11,12). Similar to previous studies, AKI occurred more commonly in male than female neonates in our study, which is secondary to the increased incidence of septicemia and respiratory distress syndrome in male infants (8)(9)(10).…”

Section: Discussionsupporting

confidence: 92%

Predictive Factors for Acute Renal Failure in Neonates with Septicemia

Nickavar

Khosravi

Mazouri

2017

Arch Pediatr Infect Dis

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Objectives: Septicemia is an important cause of acute kidney injury (AKI) in neonates admitted to neonatal intensive care units. The aim of this study was to identify the predictive factors for AKI in neonates with culture-proven septicemia.Methods: Medical records of 138 newborns with septicemia were evaluated in 2 groups with (n, 65) and without (n, 73) AKI. Results:The mean age at diagnosis of AKI was 11.31 ± 9.92 days. AKI was more common in neonates with lower gestational age, birth weight, age, blood pressure, platelet count, and serum pH at admission. Moreover, AKI was associated with an increased incidence of intubation at birth, inotrope treatment, shock, disseminated intravascular coagulation (DIC), mechanical ventilation, and morality. Gestational age, initial serum pH, and DIC were the only independent predictors of AKI in the multivariate analysis. In addition, serum pH at admission was the most accurate laboratory marker for the prediction of AKI with 83% sensitivity and 60% specificity. Conclusions:Monitoring of renal function is highly recommended in low-birth-weight infants with severe septicemia.

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Section: Discussionsupporting

confidence: 92%

Predictive Factors for Acute Renal Failure in Neonates with Septicemia

Nickavar

Khosravi

Mazouri

2017

Arch Pediatr Infect Dis

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“…These data correlate with the data described in several studies. [16][17] But we think that the incidence of neonatal AKI in our NICU is likely higher than it is reported in the present study. Namely, infants very often have non oliguric AKI.…”

Section: Discussioncontrasting

confidence: 64%

Acute Kidney Injury in Newborns

Timovska

Cekovska

Tosheska-Trajkovska

2015

Prilozi

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Objective: Acute kidney injury is common condition in the neonatal intensive care unit and it is associated with poor outcome. The incidence of neonatal AKI is the highest one followed by adults and children, depending on different factors such as the gestational age, birth weight, contributing conditions and the facilities of the neonatal intensive care unit. The aim of the study was to determine the incidence, risk factors and the outcome of the neonatal acute kidney injury. Subjects and Methods: This was a clinical, prospective study that was performed in a referent NICU at the University Children's Hospital in Skopje. All neonates admitted from January 2012 to December 20014 with documented acute kidney injury were included. The medical data records of the admitted neonates with AKI were analyzed. The material was statistically processed using methods of the descriptive statistics. Results: During the study period 770 newborn infants were admitted to the NICU and 50 (6.5%) infants developed acute kidney injury. The male to female ratio was 2.1:1. Most of the neonates involved in the study were neonates born at term (62%). Oliguric AKI was found in 28 cases (56%) and no oliguric in 22 cases (44%). The prevalence of prerenal, renal and post renal AKI were 78.5%, 19.5% and 2.0% respectively. Perinatal asphyxia was the most common predisposing factor for AKI and was evaluated in 38% of the cases with predominance of term infants and male. The mortality rate was 32% and was significantly higher in the group of patients with congenital heart diseases. Conclusion: AKI is a life threatening condition with still high mortality rate. Early recognition of the risk factors and the rapid effective treatment of the contributing conditions will reduce AKI in the neonatal period.

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“…In a group of neonates with AS ≤ 6, Gupta et al (19) found that the incidence of AKI was 47% and mortality was 14.1%. Those findings were confirmed by similar results of other authors (1,23,24). Choker et al (25) found that neonates with AKI had significantly lower GS and BW than those without AKI.…”

Section: Discussionsupporting

confidence: 85%

Urinary kidney injury molecule-1 rapid test predicts acute kidney injury in extremely low-birth-weight neonates

et al. 2015

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Background:The new urinary and serum biomarkers are discovered and are being investigated. With them we can diagnose acute kidney injury (AKI) faster and more precisely and they also have a significant role in the outcome prediction. Methods: The study included 22 extremely low-birthweight neonates who were hospitalized in the neonatal intensive care units. They were divided into two groups based on serum creatinine (SCr) level-with and without AKI. Detection and quantification of urinary kidney injury molecule-1 (uKIM-1) was done on the third day of life, using commercially available KIM-1 rapid test. Subsequently, measurements were repeated only in subjects who were diagnosed with AKI, at different values of SCr. results: Logistic regression analysis showed that AKI is an independent risk factor for mortality. In a group of neonates with AKI, 50% of neonates administered the KIM-1 rapid test showed positive findings. KIM-1 rapid test was positive in patients with a wide range of SCr levels (range of 78.73-385 µmol/l), but all subjects had oliguria and died in the next 24 h. conclusion: KIM-1 is a significant predictor of death. On the other hand, our study failed to prove that KIM-1 rapid test has any significance for early prediction of AKI.

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Neonatal acute kidney injury in a tertiary center in a developing country

Abstract: The prevalence of newborn AKI in our Thai tertiary center over 24 years was 6.3% of admitted newborns. Sepsis was the most common cause of AKI and sepsis-induced AKI is the most common cause of death. Disease etiology was the only risk factor for mortality.

Cited by 48 publications

References 18 publications

Predictive Factors for Acute Renal Failure in Neonates with Septicemia

Predictive Factors for Acute Renal Failure in Neonates with Septicemia

Acute Kidney Injury in Newborns

Urinary kidney injury molecule-1 rapid test predicts acute kidney injury in extremely low-birth-weight neonates

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