Abstract

Objective of our study was to find out the incidence of Acute Kidney Injury (AKI) in neonates with their immediate outcome, how stages of AKI is related to mortality and what are the common co–morbid conditions among AKI deaths. In this observational prospective study we included the newborns with features suggestive of AKI with exclusion criteria of major congenital anomaly and extreme prematurity. AKI was diagnosed and classified according to the KDIGO (Kidney Disease: Improving Global Outcome) guideline taking serum creatinine and urine output as determinant. Cases were followed up till discharge or death. Now we have figured out the incidence of AKI in different stages, its immediate outcome and what are the percentage of mortality within each stage. Among the AKI deaths, we sort out the associated co-morbid conditions like perinatal asphyxia, sepsis, shock, prematurity, etc. and analyzed all the results statistically. Out of total 1923 neonates admitted during the 18 months study period we found AKI in 119 neonates (6.18%). Among them 75(63.03%), 26(21.85%) and 18(15.12%) neonates were in KDIGO stage 1, 2 and 3 respectively. We were able to discharge 68 neonates, 30 expired and the rest were referred out or LAMA. When we compare mortality among different stage, we found that it was 9.33% in stage 1 and 38.46% and 72.22% in stage 2 and 3 respectively. Among the various co-morbid conditions present among the expired neonates, sepsis(13) and perinatal asphyxia(12) were the leading ones followed by prematurity(3)and PPHN(2). So the conclusion is, if we can identify AKI early then chance of survival is better as we have shown in our study that mortality increases with the advancement of AKI stage. Sepsis and asphyxia ware the two most common co-morbid conditions among AKI deaths in our study.

Key words: Acute Kidney Injury (AKI), Co-morbidity, Mortality, Neonate