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Year : 2020  |  Volume : 3  |  Issue : 2  |  Page : 58-63

A prospective study of acute kidney injury in outborn neonates admitted in a tertiary care center in Western Rajasthan

Department of Pediatrics, Dr. S.N. Medical College, Jodhpur, Rajasthan, India

Correspondence Address:
Mohan Makwana
E-22/10, Umaid Hospital Campus, Jodhpur - 342 001, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2589-9309.305898

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Background: Acute kidney injury (AKI) is common in critically ill neonates and is associated with increased risk of morbidity and mortality. Methods: This study was conducted in a tertiary care hospital of western Rajasthan over a period of 1 year on neonates born elsewhere. Neonates fulfilling the neonatal Risk, Injury, Failure, Loss, and End-Stage (nRIFLE) criteria for AKI were included and and were investigated as per protocol. Results: Out of 3422 neonates admitted in neonatal ICUs, 983 (28.7%) neonates had AKI as per the nRIFLE criteria. The majority (83.6%) of the neonates with AKI were from rural background. Most (75.6%) infants were admitted within the first 7 days of life, with male predominance (ratio of boys to girls 1.7:1), and the mean admission weight was 2.4 ± 0.5 kg. The rate of neonatal AKI was highest during summer months. The highest AKI stages by the nRIFLE criteria were risk (R) in 57.9%, failure (F) in 24.6%, and injury (I) in 17.4% of the cases. Factors associated with AKI were dehydration (53.7%) related to high ambient temperatures, sepsis (35.7%), perinatal asphyxia (19.9%), and respiratory distress (15.8%). Mortality rates were 11.9%, 10.5%, and 20.2% in category R, I, and F, respectively. Conclusions: High prevalence of neonatal AKI in this centre was due to dehydration related to high ambient temperatures. AKI was associated with high rates of morbidity and mortality.

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