Predisposing factors and outcome of acute kidney injury in neonates

  • S Ramesh
Keywords: Acute kidney injury, Cardiopulmonary compromise, Excess weight loss, Perinatal asphyxia, Sepsis


Introduction: Acute kidney injury (AKI) influences the risk of mortality in sick neonates. Predicting AKI on the basis
of risk factors may help in early intervention and improved outcome. Objective: The aim of this study is to identify the
predisposing factors, clinical features, and outcome of AKI in neonates. Methodology: A retrospective study was carried out
from September 2011 to August 2015. AKI was diagnosed if any one of the following is present: (1) Baby’s serum creatinine
more than 1.5 mg/dl for at least 24–48 h with normal maternal renal function, (2) baby’s serum creatinine increases by more
than 0.3 mg/dl over 48 h. All babies with AKI during the study were included in the study. Result: Twenty-five babies with
AKI were studied. Male predominance was seen. Babies presented at a median age of 3 days interquartile range ([IQR] 2–5)
with the median gestational age of 36 weeks (IQR 28–40) and median birth weight of 2490 g (IQR 1885–2875). Perinatal
asphyxia (44%), blood culture positive sepsis (24%) and excess weight loss due to inadequate feeds (20%) were common
causes for AKI. About half of the cases have received mechanical ventilation and/or inotropes. Nephrotoxic drug exposure was
seen in 44% of cases. Only one-third of the babies had oliguria. Fluid boluses, diuretics, and sodium bicarbonate to correct
acidosis were commonly used for medical management. Only 12% of cases required peritoneal dialysis. One baby expired.
Conclusion: Perinatal asphyxia, sepsis, excess weight loss, and cardiopulmonary compromise predisposes to AKI in neonates.
Many babies improve with medical management.

How to Cite
Ramesh, S. (2017). Predisposing factors and outcome of acute kidney injury in neonates. Indian Journal of Child Health, 5(1), 46-49. Retrieved from
Original Articles