Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India
Introduction: Acute Kidney Injury (AKI) is a serious condition in neonatal care. It complicates the management necessitating the restrictive use of medications. Aim: To evaluate clinical profile, identify associated and prognostic factors in newborns with AKI. Materials and Methods: This was a c...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2017-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9327/23398_CE[Ra1]_F(RK)_PF1(GU_RO)_PFA(AK)_PF2(NE_SY_DK).pdf |
| Summary: | Introduction: Acute Kidney Injury (AKI) is a serious condition
in neonatal care. It complicates the management necessitating
the restrictive use of medications.
Aim: To evaluate clinical profile, identify associated and prognostic factors in newborns with AKI.
Materials and Methods: This was a case control study done
between January 2008 to January 2010. Total 1745 newborns
were admitted, of which 74 babies had AKI. It was defined
as serum creatinine >1.5mg/dl. Control group was selected
randomly from the hospital numbers of the newborns derived
from the electronic registry with serum creatinine below 1.5 mg/
dl. Demographic variables like birth weight, gender, gestational
age, admission age, growth restriction, Apgar scores, electrolyte
levels; and common clinical conditions like asphyxia, sepsis,
meningitis, persistent pulmonary hypertension, Necrotizing
Enterocolitis (NEC), mechanical ventilation, congenital heart
disease; were compared amongst the two groups. Information
was obtained from the admission register, admission files,
labor register of obstetrics and gynaecology department and
electronic registry. Chi square/independent sample t-test as
applicable and logistic regression were used to establish an
association of various factors and outcome with AKI.
Results: The incidence of AKI in our study was 4.24%.
Demographic variables more common in AKI group were inborn
(p=0.011), male gender (p=0.032), term gestation (p=0.001),
Appropriate for gestational age (0.001), higher birth weight
(p<0.001), full term (p<0.001), sepsis (p<0.001), NEC (p=0.042),
low ApGAR scores at one minute (p=0.011) and five minute
(p=0.003). However, on multivariate logistic regression only male
gender [Odds Radio (OR)=2.84, Confidence Interval (CI)=1.12-
7.21] and Sepsis (OR=14.46, CI=4.5-46.46) were associated
with AKI. Respiratory distress syndrome was more prevalent in
the control group (p<0.003). No need of mechanical ventilation
and absence of shock, improved the survival.
Conclusions: 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). |
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| ISSN: | 2249-782X 0973-709X |