Incidence, Risk Factors, and Outcome of Acute Kidney Injury in Critically Ill Neonates

Abstract Background. Acute kidney injury is a common problem in critically ill neonates in Neonatal Intensive Care Unit (NICU). Critically ill neonates commonly have various risk factors for renal injury, including prematurity, asphyxia, sepsis, nephrotoxic drug exposure, dehydration and bleeding episode. We intended to analyze the incidence, risk factors, and outcome of acute kidney injury in neonates. Method. This prospective cohort study was conducted at NICU of Prof. Dr. R.D. Kandou General Hospital, Manado, in August 2019 to January 2020. Subjects were neonates who had received parental consent to participate and was willing to fill out a research form. The data obtained were analyzed using the chi-square test to compare groups of categorical variables and logistic regression test to determine the potential for predictive covariates in acute renal injury. This study was conducted under the approval of the Health Ethics Committee of Prof. Dr. Dr. R.D. Kandou, Manado. Result. This study found significant and strong association between sepsis and nephrotoxic drug exposure with acute kidney injury. Asphyxia with kidney disorders had strong relationship with renal injury. There was weak, significant association between respiratory distress and kidney injury. Meanwhile, bleeding and dehydration status were not significantly associated with kidney injury. Prematurity and acute kidney injury had significant negative relationship. From all the variables, sepsis, nephrotoxic drug exposure and prematurity were significantly associated with renal injury. This study also found weak association between acute kidney injury and mortality in critically ill neonates.