Neurological Manifestation of Neonatal Acute Kidney Injury: Focusing on the Clinico-Radiological Profile

Purpose This study aimed at studying the neurological manifestation of neonatal acute kidney injury, focusing on the clinico-radiological profile. Methodology In this cross-sectional study, newborns hospitalized in the neonatal intensive care unit of a tertiary care hospital were enrolled over a study period of one year. As per the Kidney Disease: Improving Global Outcome (KDIGO) criteria, 74 neonates were enrolled, and magnetic resonance imaging (MRI) was performed on the same neonates. Result In this study, acute kidney injury (AKI) was seen more often in neonates with admission weights between 1,500 and 2,499 grams, accounting for 52.7% of total study participants. In the current study, neonates admitted with AKI presented more with signs and symptoms of encephalopathy, such as lethargy (78.4%), seizures (64.8%), and irritability (35.1%) at admission. Signs and symptoms of fever and decreased urine output were more common after the first week of life. Abnormal MRI findings were observed in 64.9% of neonates with AKI. The mean blood urea and serum creatinine levels in neonates with abnormal MRI were 188.14 ± 108.25 mg/dL and 2.93 ± 2.16 mg/dL, respectively. The mean blood urea and serum creatinine levels in neonates with normal MRI were 169.84 ± 65.45 mg/dL and 2.41 ± 1.85 mg/dL, respectively. Of the 74 neonates enrolled with AKI, 12 (16.21%) had CSVT. These neonates had a mean blood urea level of 231.58 ± 111.66 mg/dL (p = 0.047) and a mean creatinine level of 3.77 ± 2.78 mg/dL. Conclusion Neonatal AKI has a variable presentation with high mortality and morbidity. Elevated serum urea and creatinine can be used to predict CSVT.