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...
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| Format: | Article |
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JCDR Research and Publications Private Limited
2017-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/9327/23398_CE[Ra1]_F(RK)_PF1(GU_RO)_PFA(AK)_PF2(NE_SY_DK).pdf |
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| author | Satvik Chaitanya Bansal Archana Somashekhar Nimbalkar Amit R Kungwani Dipen Vasudev Patel Ankur Rajinder Sethi Somashekhar Marutirao Nimbalkar |
| author_facet | Satvik Chaitanya Bansal Archana Somashekhar Nimbalkar Amit R Kungwani Dipen Vasudev Patel Ankur Rajinder Sethi Somashekhar Marutirao Nimbalkar |
| author_sort | Satvik Chaitanya Bansal |
| collection | DOAJ |
| description | 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). |
| first_indexed | 2024-12-23T10:23:57Z |
| format | Article |
| id | doaj.art-81dccd43459a4760af054c05a89b3a6d |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-23T10:23:57Z |
| publishDate | 2017-03-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-81dccd43459a4760af054c05a89b3a6d2022-12-21T17:50:37ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-03-01113SC01SC0410.7860/JCDR/2017/23398.9327Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western IndiaSatvik Chaitanya Bansal0Archana Somashekhar Nimbalkar1Amit R Kungwani2Dipen Vasudev Patel3Ankur Rajinder Sethi4Somashekhar Marutirao Nimbalkar5Senior Resident, Department of Paediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India.Associate Professor, Department of Physiology, Pramukhswami Medical College, Karamsad, Gujarat, India.Senior Resident, Department of Paediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India.Associate Professor, Department of Paediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India.Assistant Professor, Department of Paediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India.Professor, Department of Paediatrics, Pramukhswami Medical College, Karamsad, Gujarat, 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 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).https://jcdr.net/articles/PDF/9327/23398_CE[Ra1]_F(RK)_PF1(GU_RO)_PFA(AK)_PF2(NE_SY_DK).pdfacute kidney injurycreatininemortalitysepsisshock |
| spellingShingle | Satvik Chaitanya Bansal Archana Somashekhar Nimbalkar Amit R Kungwani Dipen Vasudev Patel Ankur Rajinder Sethi Somashekhar Marutirao Nimbalkar Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India Journal of Clinical and Diagnostic Research acute kidney injury creatinine mortality sepsis shock |
| title | Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India |
| title_full | Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India |
| title_fullStr | Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India |
| title_full_unstemmed | Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India |
| title_short | Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India |
| title_sort | clinical profile and outcome of newborns with acute kidney injury in a level 3 neonatal unit in western india |
| topic | acute kidney injury creatinine mortality sepsis shock |
| url | https://jcdr.net/articles/PDF/9327/23398_CE[Ra1]_F(RK)_PF1(GU_RO)_PFA(AK)_PF2(NE_SY_DK).pdf |
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