Frequency of acute renal injury in neonates with respiratory distress syndrome.

Abstract

Objective: To determine the frequency of acute kidney injury (AKI) in neonates with acute respiratory distress syndrome (RDS). Study Design: Cross-sectional study. Setting: Neonatal Intensive Care Unit (NICU) of National Institute of Child Health, Karachi, Pakistan. Period: January 2023 to June 2023. Material & Methods: A total of 118 neonates of both genders, born below 37 weeks of gestation and having RDS were analyzed. Demographic, clinical and laboratory parameters were noted. Frequency of AKI was determined while final outcome was noted in terms of discharged or mortality. Results: Of 118 neonates, 55.1% were girls. The mean gestational age: 33.11±1.76 weeks, mean admission age 8.30±9.0 hours, and mean birth weight 1.53±0.27 kg. AKI occurred in 50.8% of neonates with RDS. Mortality was reported in 46.6% cases. Factors associated with AKI included grunting at admission (63.3% vs. 43.1%, p=0.028), need for mechanical ventilation (35.0% vs. 12.1%, p=0.003), and platelet count on admission (p=0.042). Factors associated with mortality included lower Apgar score at minute 5 (p<0.001), resuscitation at delivery (p<0.001), grunting at admission (p=0.005), platelet count at admission (p=0.001), leukocyte count at admission (p=0.003), and the need for mechanical ventilation (p<0.001). Conclusion: Very high frequency of AKI (50.8%) in neonates with acute RDS was noted. Mortality was associated with lower Apgar scores, resuscitation at delivery, grunting at admission, low platelet and leukocyte counts, and the need for mechanical ventilation.