Renal function status after 6 months in term sick newborns with acute kidney injury

Abstract

Background: Assumption that resolution of acute kidney injury (AKI) is followed by complete renal recovery has been challenged by recent studies in adults and children. However, data in term newborns are scarce. This study was done to observe deranged renal parameters and hence risk factor for chronic kidney disease at 6 months of age in term newborns who develop AKI due to various causes. Methods: This was a descriptive cohort study in term newborns developing AKI (nRIFLE). Sixty-one babies completed the study for final analysis. After 6 months of follow-up, clinical and laboratory renal parameters were studied. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. Results: The median gestational age of cohort was 38 weeks, and the mean birth weight and length were 2.8 ± 0.45 kg and 48.3 ± 2.25 cm, respectively. Sepsis was the most common etiological factor in 54% cases of AKI followed by birth asphyxia (34%). The median age and serum creatinine at diagnosis of AKI were 4 days and 2.7 mg/dL, respectively. Nearly 77% of cases (n = 47) were oliguric and the median value of fractional excretionof sodium was 0.87 (0.688–1.335). One (1.64%) neonate was in risk stage, 8 (13.11%) in injury, and 52 (85.246%) in failure stage. At 6 months of follow-up, 41% (n = 25) had decreased serum bicarbonate values. Four out of 61 patients (6.56%) had reduced estimated glomerular filtration rate, while 15 (24.59%) had hyperfiltration. Overall, 63.93% (n = 39) of the cases had one or more renal parameters deranged at 6 months. Conclusion: A large proportion of term newborns with AKI continue to have deranged renal parameters, therefore they need careful monitoring for long duration.