Background Acute kidney injury is a serious clinical problem in neonatal intensive care unit. It is defined as a sudden decrease in kidney function resulting in derangements in fluid balance, electrolytes, and waste products. SNAPPE 2 score is a useful tool for assessing the severity of the disease that correlates with neonatal mortality.

Objective The aim of the study was to determine the incidence of AKI and the role of SNPPE 2 score in predicting mortality and morbidity in AKI in neonates.

Methods The study was designed as a prospective, clinical, epidemiological investigation conducted in the period of three years, which included 100 newborn infants (50 with AKI and 50 without AKI) hospitalized in NICU of University Children’s Hospital. The severity of the illness of hospitalized newborn infants was estimated with SNAPPE 2 score realized in the first 12 hours of admission in NICU. Medical data records of admitted neonates with AKI were analyzed. The material was statistically processed using methods of descriptive statistics.

Results During the study period 770 newborns were hospitalized in NICU due to various pathological conditions and 50 newborns have been selected with AKI. As the control group, 50 newborns were taken with comparable associated pathological conditions, but without kidney injury. The calculated prevalence of AKI in neonates was 6.4%. Most of involved neonates in the study in both groups (AKI and non AKI) were born at term (64% and 54%) with predominance of male (68% and 60%). The mortality rate was higher in newborns with AKI than control group (36% vs 24%). In half of newborn infants with AKI predominate severe score level, while in control group predominate median score level (42%). There is a significant difference between the mean score value in neonates with AKI and lethal outcome compared to neonates with AKI without lethal outcome (70.73 ± 18.6 vs. 40.2 ± 16.6).

Conclusion Acute kidney injury is a life threatening condition with still high mortality rate. The severity of the illness of hospitalized newborn infants in NICU is estimated by SNAPPE 2 score. The high score level is associated with the severity of the disease and higher mortality. Appropriate treatment of newborns with severe kidney injury improves the outcome and reduces the mortality of the disease.