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2017 ; 11
(3
): SC01-SC04
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Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3
Neonatal Unit in Western India
#MMPMID28511469
Bansal SC
; Nimbalkar AS
; Kungwani AR
; Patel DV
; Sethi AR
; Nimbalkar SM
J Clin Diagn Res
2017[Mar]; 11
(3
): SC01-SC04
PMID28511469
show ga
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 prog-nostic 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).