Prognostic Factors and Mortality Rate in Neonates with Acute Renal Injury in NICU

Acute Renal Injury (AKI) is a frequent clinical condition in the Neonatal Intensive Care Units (NICUs). Most AKI causes are preventable; performing rapid preventive, diagnostic, and therapeutic measures could prevent the potential complications. The present study was conducted to define the risk factors and mortality rates of neonates with and without AKI admitted in the NICU of a tertiary care hospital. Demographic and biochemical data of NICU of Mahdieh Hospital were collected and analyzed. More than twofold increase in normal serum creatinine level or >0.8 mg/dl (for infants > 4 days age) was defined as AKI. All newborns were divided into two groups: with and without AKI. Risk factors and mortality rates were compared in the 2 groups. The mortality rate of newborns with AKI was 4.5%. The other risk factors for mortality in neonates with AKI were as follows: Hyaline Membrane Disease (HMD) (P <0.03), using mechanical ventilation (P <0.041), using surfactant (P <0.04), first minute Apgar score <5, PCO2 >60 mmHg (P <0.035), birth weight < 2500 g (P <0.003) and serum creatinine (SCr) level >1 mg/dl (P <0.003). ROC Curve revealed that low birth weight was the most significant risk factor for mortality of neonates with AKI admitted in the NICU. Mortality related to AKI was associated with HMD, using mechanical ventilation, the need to surfactant use, low Apgar score, high blood PCO2, high serum creatinine level, and low birth weight.