The Incidence and Potential Risk Factors of Acute Kidney Injury in Neonatal Intensive Care Unit: Single Center Experience.

Document Type : Original Article

Authors

Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.

Abstract

Introduction: Acute Kidney Injury (AKI) is associated with significant morbidity and mortality in newborns.
Aim of the study: This study aims to investigate the incidence, potential risk factors, and the outcomes of neonates diagnosed with AKI.
Methods: All admissions with AKI were recruited from neonatal intensive care unit at Cairo University Children’s Hospital, during a six-month duration. The diagnosis of AKI was made based on n-RIFLE criteria. Data collected included maternal risk factors, gestational age, gender, birth weight, Apgar scores, vital signs, urine output, use of mechanical ventilation, and cause of admission. We reviewed the patients’ investigations including complete sepsis profile, kidney function tests, urine analysis, and bedside abdominopelvic ultrasound.
Results: Of 1045 admissions, 101 patients (9.7%) developed AKI in the current study, with male sex predominance. Respiratory distress (RD) was the most common contributing factor of AKI (72.3%), followed by sepsis (14.9%). There was no statistically significant difference in incidence, severity, and mortality in patients with AKI as regards to gestational age, and weight at birth.  The need for mechanical ventilation, and low APGAR score were significantly associated with high mortality (p=0.001, and p=0.02, respectively).
Conclusion: We concluded that, AKI is a common complication in neonates in the NICU with significant impact on morbidity and associated with many preventable risk factors. The incidence of mortality was significantly higher in patients with oliguria than those with non-oliguria. Every 1 mg % increase in creatinine/day increased mortality rate [OR = 1.393, 95% CI 0.78 to 2.49].

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