Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western IndiaCorrespondence Address :
Dr. Somashekhar Marutirao Nimbalkar,
Department of Paediatrics, Pramukhswami Medical College, Karamsad-Anand-388325, 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).
Acute Kidney Injury, Creatinine, Mortality, Sepsis, Shock
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 [serial online] 2017 March [cited: 2017 May 22 ]; 11:SC01-SC04. Available from
Date of Submission: Aug 07, 2016
Date of Peer Review: Aug 31, 2016
Date of Acceptance: Oct 04, 2016
Date of Publishing: Mar 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
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