Incidence of Acute Kidney Injury in Asphyxiated Babies in Abia State University Teaching Hospital, Aba, Nigeria

Background: Perinatal asphyxia is a major contributor to neonatal morbidity and mortality, especially in resource-poor countries where facilities for neonatal care are limited. One of the major complications of perinatal asphyxia is acute kidney injury (AKI). AKI in infants with perinatal asphyxia signifies a significant clinical problem that can have far-reaching impacts. Early recognition, prompt institution of conservative management, and close monitoring of renal function are essential to minimize morbidity, mortality, and long-term consequences in these infants. In Nigeria, there is a paucity of data on AKI in asphyxiated newborns. Few studies have been carried out, but none has been done at Abia State University Teaching Hospital (ABSUTH) South-East Nigeria. Methods: We conducted a cross-sectional descriptive study including 155 full-term neonates admitted at the special baby care unit of ABSUTH, Aba, with perinatal asphyxia. Asphyxiated neonates were grouped into severe (0-3), moderate (4-5), and mild (6) based on Apgar score at 5 minutes. Serum creatinine was done daily for the first week of life and the result was documented in the patient’s clinical progress sheet. Subjects enrolled in the study were categorized within 72 hours of admission into the AKI group and no-AKI group. Acute kidney injury was defined as serum creatinine of 133µmol/L or a percentage increase in serum creatinine of ≥ 50% (1.5-fold from the baseline). Results: Of the 155 infants enrolled, 43.9% had mild perinatal asphyxia, 29% had moderate, and 27.1% had severe perinatal asphyxia. The incidence of AKI, using serum creatinine ≥ 133µl/L was 48.8%. This was found to be statistically significant with a p-value <0.05. Conclusion: AKI occurs more commonly among patients with perinatal asphyxia. Moreso with increasing severity of asphyxia. There is a need for more studies to be done using more sensitive diagnostic markers of AKI.