Aetiological Profile and Outcomes of Acute Kidney Injury among Neonates Admitted in a Neonatal Intensive Care Unit at a Tertiary Care Hospital, Northeast India: A Prospective Cohort Study

Abstract

Introduction: Acute Kidney Injury (AKI) affects approximately 8%-24% of critically ill neonates, with a mortality rate ranging from 10%-61%. Groups of newborns at higher risk for AKI include those with perinatal hypoxia, Respiratory Distress Syndrome (RDS), premature and very low birth weight infants, and newborns with sepsis. AKI is associated with poor short-term and long-term outcomes and has a multifactorial aetiology. Aim: To evaluate the aetiological profile and short-term outcomes of AKI in neonates admitted to the Neonatal Intensive Care Unit (NICU). Materials and Methods: A prospective cohort (descriptive) study was conducted in the NICU at Gauhati Medical College and Hospital, Guwahati, Assam, India, over a period of one year, from September 1, 2021, to August 31, 2022. A total of 100 neonates exhibiting signs and symptoms of AKI according to Acute Kidney Injury Network (AKIN) criteria. Detailed neonatal history, including neonatal resuscitation, history of perinatal asphyxia, signs and symptoms of sepsis, Respiratory Distress Syndrome (RDS), or any other symptoms, were recorded. The course and outcome of the neonates during their NICU stay were noted. Data were presented in terms of frequency (n) and percentages (%). Results: Among the 100 AKI neonates, 58 were males and 42 were females, with a male-to-female ratio of 1.38:1. Out of 100 neonates, birth asphyxia constituted 40 (40%) cases, of cases, followed by sepsis in 30 (30%), RDS 27 (27%), dehydration 2 (2%), and obstructive uropathy in 1 (1%) case. Among the 100 AKI neonates, 64 (64%) cases were discharged, 35 (35%) expired, and 1 (1%) were transferred to the paediatric surgery department. Conclusion: Neonatal AKI is an independent contributor to morbidity and mortality. Therefore, early identification and prompt management are crucial for improving outcomes and prognosis.