Background and Aims Our study aims are
To study the clinical profile and associated conditions in newborns with Acute Kidney Injury (AKI) in our Level 3 Neonatal ICU.
To evaluate the incidence and outcome of newborns with AKI.
To study risk factors associated with AKI in our newborns.
Methods AKI was defined as Serum Creatinine >1.5mg/dl. Data about neonates admitted over period of three years were studied from a Level 3 Neonatal Intensive Care Unit in Western India. Parameters associated with AKI were evaluated and descriptive analysis was done.
Results Out of 1745 patients, 74 (Male-61, Female-13) patients had AKI. The incidence of AKI was 4.24 % of admitted newborns, and 80% of the babies developed AKI within first week. Incidence of AKI in outborn babies (5.83%) is higher than inborn babies (2.44%) and outborns comprised 72.97% of all AKIs (54/74). Mean Birth weight of neonates was 2.46±0.55 kg with 47.30% being LBWI. Factors associated with AKI were sepsis (91.9%), shock(64.9%), requirement of ventilation(62.2%), Perinatal asphyxia (36.5%), resuscitation (40.5%) and requirement of intubation at birth (23%). Mean Serum Creatinine was 2.87±1.81 mg/dl(1.51 to 10.05). Mean age at diagnosis was 5.76±6.64 days(1 to 41). The mortality was 20% and 51.6% patients went DAMA (Discharge Against Medical Advice).
Conclusions Mortality in patients with AKI is very high. Most AKI occurs in the first week of life and factors associated with AKI are easily recognizable and should prompt early referral of neonates.