RISK FACTORS OF ACUTE KIDNEY INJURY IN NEONATES

Abstract

OBJECTIVES: To determine the risk associated with different maternal and neonatal variables in the evolution of acute kidney injury in newborns hospitalized in critical care.

STUDY DESIGN:         Prospective cohort study.

SETTING/DURATION OF STUDY:   Department of Pediatrics, Combined Military Hospital, Lahore, Aug 2022 to Aug 2024.

METHODOLOGY:     We studied 100 neonates, of both genders, admitted for critical care in the Neonatal Intensive Care Unit. Those neonates who were lost to follow-up, or those with congenital defects of the renal and urinary tract were excluded. All patients underwent monitoring for the development of AKI, which assessed according to the modified kidney disease: Improving Global Outcomes criteria for neonates. All patients were followed up till the end of the neonatal period.

RESULTS:       Male gender (OR: 4.17, CI 95% 1.52 – 11.48, p=0.004), APGAR score at birth <8 (OR: 4.63, CI 95% 1.83 – 11.76, p<0.001), respiratory distress syndrome (OR: 42.78, CI 95% 5.18 – 353.42, p<0.001), surfactant therapy (OR: 4.81, CI 95% 1.68 – 13.76, p=0.002), requirement for mechanical ventilation (OR: 20.32, CI 95% 6.71 – 61.53, p<0.001) and a requirement for inotropic support (OR: 43.97, CI 95% 12.03 – 160.76, p<0.001) were all positively associated with the occurrence of AKI, while antenatal steroid exposure (OR: 0.33, CI 95% 0.14 – 0.812, p=0.014) appeared to be protective.

CONCLUSION:          Acute kidney injury is associated with a number of maternal, neonatal, and pregnancy factors that can be used to identify pregnancies at risk.