Summary:
Introduction: Acute kidney injury (AKI) is an important
clinical problem in sick neonate. In most patients, AKI
accompanies with a predisposing factor such as sepsis,
asphyxia and surgery. The aims of this study were to determine
the incidence, associated contributing factors and short term
outcome of AKI in hospitalized newborn infants.
Materials and Methods: This prospective cohort study was
done in Dhaka Shishu Hospital from March 2011 to
September 2011. This study included 300 sick neonates
admitted during the study period. AKI was defined when
serum creatinine level >1.5 mg/dl and BUN was >20 mg/dl
on two separate occasions at 24 hours apart. Oliguria was
defined as urine output <1ml/kg/ hr. Medical records of
those patients were reviewed and data were analyzed using
SPSS software.
Results: Fourteen babies (4.66%) out of 300 sick neonates
had AKI, of whom 64.2% were male and 35.7% female. The
term and preterm neonates were 71% and 29% respectively.
While a normal birth weight was observed in 57% cases,
35% had low birth weight and 7.14% had very low birth
weight. Sepsis was the most common (71%) association of
AKI, followed by perinatal asphyxia (52%). All patients
had more than one predisposing factors. Frequency of
oliguric kidney injury was 57% and non-oliguric was 43%.
Mortality among the hospitalized neonate with AKI was
21%.
Conclusion: This study showed that in a tertiary care hospital
AKI is not uncommon (4.66%) in neonatal care unit. It is
associated with some preventable conditions such as sepsis,
perinatal asphyxia and shock. Outcome is poor in sick
neonates with AKI (21% mortality) in comparison to sick
neonates without AKI (10.3%).
Key words: Acute Kidney Injury, Sick neonate.
(J Bangladesh Coll Phys Surg 2017; 35: 20-23)