Study of Acute Kidney Injury in Newborns Admitted in NICU at a Tertiary Care Hospital

Abstract

Introduction

Acute kidney injury (AKI) is an important cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs). Critically ill neonates are particularly vulnerable because of immature renal function, sepsis, birth asphyxia, dehydration, and exposure to nephrotoxic drugs. Early identification of AKI is important for reducing complications and improving survival.

Materials and Methods

This hospital-based cross-sectional observational study was conducted in the NICU of K.D. Medical College and Research Centre, Mathura. A total of 160 term neonates admitted to the NICU were included. Preterm neonates, neonates with congenital renal anomalies, and those without parental consent were excluded. AKI was diagnosed using modified KDIGO criteria based on serum creatinine and urine output. Relevant clinical, demographic, biochemical, and outcome data were recorded and analyzed using SPSS version 25.0.

Results

Among 160 neonates, 63 developed AKI, giving an incidence of 39.4%. Stage 1 AKI was most common (38.1%), followed by Stage 2 (33.3%) and Stage 3 (28.6%). Sepsis was the most common etiological factor (69.8%), followed by birth asphyxia (14.3%) and neonatal jaundice (12.7%). Neonates with AKI had significantly lower birth weight, lower urine output, lower serum sodium, and higher serum potassium, blood urea, and serum creatinine levels. Mechanical ventilation and vasoactive support were significantly more common among AKI neonates. Mortality was significantly higher in neonates with AKI compared to those without AKI (28.6% vs 4.1%).

Conclusion

AKI is a frequent and serious complication among NICU-admitted neonates. Sepsis, low birth weight, oliguria, and hemodynamic instability are major risk factors. Early diagnosis and prompt management are essential to improve neonatal outcomes.