Prevalence, risk factors and early mortality of Acute Kidney Injury among term neonates admitted with perinatal asphyxia in Fort Portal Hospital
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Date
2023-05
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Kampala International University
Abstract
Introduction
The failure of the newborn to begin and maintain sufficient respiration after delivery is known as perinatal asphyxia. Acute kidney injury (AKI) is common in asphyxiated newborns and is associated with complications and high mortality, but there is paucity of data about the subject in Uganda. This study was aimed at determining the prevalence, risk factors and early mortality of acute kidney injury among term neonates admitted with perinatal asphyxia in Fort Portal Hospital.
Methods
This was a hospital-based prospective cohort study at Fort Portal Hospital. A blood sample was taken to measure creatinine at admission and 72 hours letter. The KDIGO criteria was used to diagnose AKI. The participants were followed up to the 7th day after diagnosed. Analysis was done using SPSS version 22 in which the prevalence and mortality were reported using descriptive statistics while the risk factors were determined using binary logistic regression.
Results
Of the 175 neonates enrolled in this study, majority presented at 48-72hours (68.0%) and were male (73.7%) with an APGAR score of 6 at 5 minutes (60.6%). The prevalence of AKI was 24.6% with majority of the AKI being stage I (60.5%). The factors that were significantly associated with acute kidney injury at multivariate level were less than 4 antenatal care visits (aOR=1.972, CI=1.859-2.266, P=0.001), duration of resuscitation >20 minutes (aOR=2.580, CI=1.167-2.867, P=0.031), and presence of shock (aOR=4.636, CI=3.135-6.041, P=0.003). Mortality of Neonates with AKI was 48.8% which represents 58.3% of the observed death among term neonates with low Apgar score and neonates without AKI was 11.4%. Neonates with AKI were 4.356 times more likely to die (cOR=4.356, p=<0.001).
Conclusion
The prevalence of acute kidney injury was high. More attention should be put on assessing for AKI among neonates with birth asphyxia. Mothers should be encouraged to attend antenatal care as recommended. Also neonates with birth asphyxia should be monitored for dehydration and shock and promptly managed. Neonates diagnosed with AKI should have management directed to kidney recovery to reduce mortality.