Prediction of risk factors and outcomes of neonatal acute kidney injury.

Introduction: Neonatal Acute kidney injury (AKI) is an underestimated morbidity in the neonatal intensive care unit (ICU). However, there is a paucity of information about risk factors, outcomes, and possible preventive measures to limit its occurrence.

Aim: This study aimed to determine the prevalence of neonatal AKI in a neonatal ICU. Data obtained from this study will help to better understand current local practices and investigate possible preventive strategies.

Materials And Methods: Charts from January 2011 to December 2018 were reviewed. Neonates less than 2 weeks old who depended on intravenous fluid as a nutrition source for at least two days were included.

Results: Overall, the eight-year prevalence of neonatal AKI in the neonatal ICU was 19.6%, and severity was distributed as follows: stage 1 (46.2%), stage 2 (26.5%), and stage 3 (27.3%). Caffeine administration before 29 weeks' gestational age significantly decreased the incidence of neonatal AKI. The incidence of neonatal AKI was independently associated with death (odds ratios (OR) = 7.11, P < 0.001) and extended length of hospital stay (OR = 2.47, P < 0.001). In the multivariate regression model, vancomycin (AOR = 1.637, P < 0.004), loop diuretics (AOR = 2.203, P < 0.001), intraventricular hemorrhage (AOR = 2.605, P < 0.001), surgical intervention (AOR = 1.566, P < 0.008), mechanical ventilation (AOR = 1.463, P < 0.015), and dopamine administration (AOR = 2.399, P < 0.001) were independently associated with neonatal AKI.

Conclusion: Neonatal AKI occurred in one-fifth of the study population in a neonatal ICU. Outcomes can be improved by identifying high-risk infants and cautiously monitoring kidney function.