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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

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Study of neonatal acute kidney injury based on KDIGO criteria

Poorva Gohiya1, Jayashree Nadkarni1, Manish Mishra1

  • 1Department of Pediatrics, Gandhi Medical College, Bhopal, India.

Pediatrics and Neonatology
|September 26, 2021
PubMed

Insights

Acute kidney injury (AKI) affects 21% of at-risk neonates, with higher mortality in severe cases. Early identification and intervention for conditions like hypoxic ischemic encephalopathy (HIE) and sepsis are crucial for better outcomes.

Area of Science:

  • Pediatric Nephrology
  • Neonatal Intensive Care
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) in critically-ill neonates is linked to increased long-term chronic kidney disease (CKD) risk.
  • Preventing and managing neonatal AKI is vital for reducing long-term renal morbidity.
  • This study investigated AKI incidence, contributing factors, and outcomes in high-risk term neonates.

Purpose of the Study:

  • To determine the incidence of AKI in at-risk term neonates admitted to the NICU.
  • To identify factors contributing to AKI development in this population.
  • To evaluate the outcomes of AKI in neonates, including mortality rates.

Main Methods:

  • A prospective study enrolled 196 term neonates admitted to the NICU with conditions like sepsis, HIE, dehydration, and respiratory distress.
  • Data collected included maternal and neonatal history, vital signs, and clinical signs.
  • Urine output was monitored, and serum creatinine levels were used to stage AKI based on modified KDIGO criteria.

Main Results:

  • The incidence of AKI was 21% (107 out of 510 admissions).
  • Mortality was significantly higher in neonates with AKI stage III (88.9%, p < 0.001).
  • Multivariate analysis showed significantly higher risks of AKI associated with HIE (35.293x), sepsis (35.701x), dehydration (30.260x), and respiratory distress (10.366x).

Conclusions:

  • AKI incidence is high among at-risk neonates.
  • Modified KDIGO criteria are feasible for early AKI identification in neonates.
  • Early diagnosis and intervention for HIE, sepsis, dehydration, and respiratory distress can prevent AKI progression and improve prognosis.
Abstract

Keywords:
AKIHIEmortalityneonatessepsis

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