A Cohort Study of Acute Kidney Injury in Egyptian Neonates; Etiology, Risk Factors, Diagnosis and Three Months Follow Up. | ||
| GEGET | ||
| Article 1, Volume 16, Issue 1, June 2021, Pages 1-13 PDF (546.99 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/geget.2021.187043 | ||
| Authors | ||
| Mohammad Abdelmonaem Sharaf; Wafaa Osman Ahmed* | ||
| Department of Pediatrics, Nephrology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt. | ||
| Abstract | ||
| Introduction: Acute kidney injury (AKI) is a major contributor of neonatal mortality and morbidity. Understanding the different anatomy of the neonatal kidney could help physician understand pathology of AKI and consequently could treat it efficiently. Aim of the study: This one year duration prospective Cohort study involved twenty seven admitted neonates who had acute kidney injury (AKI). Methods: Laboratory and radiologic diagnosis of AKI, further AKIN and pRIFLE classification and follow up after one and three months. Results: AKI had an incidence of 1.35%, mainly in full-term (59%). Hypertension was presented in full-term (75%) and preterm (45.5%). Hematuria presented by 18.8% (full-term) and 27.3% (preterm). Proteinuria occurred in full-term (46.7%) and preterm (36.4%). Urinary tract infection was more among (45.5%) preterm than full term (25%). Oliguric AKI was found in full term (68.8%) and preterm (72.7%). Anuric AKI present in full-term (31.1%) and preterm (9.1%). Post renal AKI were present 18.8 %( full term) and 9.1 %( preterm). Perinatal asphyxia (18.8%) and sepsis (27.3%) were the most common risk factor. Both full-term (37.5%) and preterm (18.2%) needed peritoneal dialysis. Ultrasonography showed bilateral Grade 2 (50%) and 1(25%) nephropathy and bilateral back pressure (18%). pRIFLE was inversely correlate with age and urine output and positively correlated with hypertension at baseline. At one month; 43.8% full-term, 18.2 % preterm were found hypertensive, 18.8% fullterm had proteinuria, pRIFLE was inversely correlated with urine output and proteinuria and eCCL was significantly improved after one month in both preterm and full-term. At three month, chronic kidney disease was 12.5% and 9.1% in full-term and preterm respectively. Total recovery was higher in preterm neonates than in full-term ones. Conclusion: Sepsis and asphyxia are considered the most common causes of AKI. Limitation: A longer follow up is mandatory. Further follow up studies of AKI in preterm neonates are mandatory. | ||
| Keywords | ||
| Key words: AKI; pRIFLE; AKIN; Neonate; Critically ill; NICU | ||
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