The incidence of acute kidney injury amongst very low birth weight neonates in the neonatal unit at Universitas Academic Hospital during the period of January 2016 to June 2016
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Date
2019-12
Authors
Ngwenyama, P. Z.
Journal Title
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Volume Title
Publisher
University of the Free State
Abstract
Background. Acute kidney injury is common amongst patients admitted in neonatal intensive care. It is associated with mortality and mobility especially in very low birth weight infants. We diagnose and define Acute kidney injury using the kidney disease improving global outcomes guidelines and looked at the incidence especially before two weeks of age. Objectives. The main objective of this study is to determine the incidence of Acute Kidney injury in Very low birth neonates admitted at neonatal intensive care unit of the Universitas Academic Hospital, from January 2016 to June 2016. Using recent proposed neonatal Acute kidney Injury classifications by Kidney disease: Improving Global Outcomes workgroup definition modified for neonates secondary objective was to look at the risk factors associated with AKI and that the Acute kidney injury in the first two weeks of life is associated with increased mortality in Very Low birth infants. Method. This was a retrospective descriptive study of Very Low Birth Weight infants (<1500) infants admitted in Neonatal Intensive Care Unit at the Universitas Academic Hospital. This study included 58 patients that fulfilled the inclusion criteria and other patients were excluded. Patients’ data were obtained through files, Medical records (Meditech) and National Laboratory health services. KIDGO (Kidney disease improving global outcomes) guidelines was used to make the diagnoses of Acute kidney Injury. Results were then classified as Early and Late onset Acute kidney injury and creatine categorized to look at the outcome. Ethical approval was obtained from Health Sciences Ethic committee: Faculty of Health sciences of the University of Free state. Results. The overall incidence of Acute kidney injury was noted to be 8.6 %(n=7). The incidence of AKI in the early onset Acute Kidney injury group were 6.9 % (n=4) as compared to lower rates of 5.2% (n=3) in the late onset Acute kidney injury group. The most common risk factors for Acute kidney injury was noted to be Sepsis, drug exposure, Perinatal asphyxia and Respiratory distress syndrome. Suspected Sepsis being the highest at 80%. There was a 14.28% (n=1) mortality rate amongst those who had Neonatal Acute kidney injury. Conclusion. Neonatal AKI is common among VLBW infants in our setting corresponding to other single Centre studies in developed countries. However, we could not establish a relationship between Acute kidney injury and in hospital increased mortality. Risk of Acute kidney injury among infants diagnosed with suspected sepsis was higher compared to those without suspicion of sepsis.
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Keywords
Dissertation (M.Med. (Paediatrics and Child Health))--University of the Free State, 2019, Acute kidney injury, Creatinine, Risk factors, Kidney disease improving global outcome