A Study to Evaluate the Incidence, Risk Factors and Etiology of Acute Kidney Injury in Newborns Admitted in Neonatal Intensive Care Unit

Introduction: Acute Kidney Injury (AKI) is the inability of the kidneys to excrete nitrogenous waste products and maintain fluid and electrolyte homeostasis. It is fairly common in newborn population and is a major contributor of neonatal mortality and morbidity. The underlying pathophysiology includes decreased renal perfusion due to various causes resulting in decreased urine output, rising serum creatinine and deranged fluid and electrolyte homeostasis. Aim and Objectives: To evaluate the incidence, risk factors and etiology of acute kidney injury in newborns admitted in neonatal intensive care unit. To study the incidence of acute kidney injury in newborns admitted in NICU. To study the etiology, clinical course and outcomes of newborns presenting with acute kidney injury. Methodology: After getting approval from College Research Committee (CRC) and Institutional Ethics Committee (IEC), SARASWATHI INSTITUTE OF MEDICAL SCIENCES, HAPUR. Neonates within the NICU fulfilling the inclusion criteria with the parental consent are included in the study. Patient particulars, demographic details, presenting features of the patient along with detailed history will be recorded. Measure Serum Creatinine levels and urine output on admission and daily basis. Frequency and outcomes are analysed using mKDIGO criteria. Results: The study population consisted of 250 neonates, with a male predominance (62%). 135 neonates (54%) were preterm, whereas 115 neonates (46%) were born at term. Among neonates delivered via vaginal delivery, 8% developed AKI, while 92% did not develop AKI. In contrast, among neonates delivered via cesarean section, 18% developed AKI, compared to 82% who did not develop AKI. Conclusion: This study highlights the high prevalence of AKI (26%) in neonates, with its incidence being particularly pronounced in preterm and low birth weight neonates. The etiology of AKI is predominantly pre-renal (60%), followed by intrinsic renal (30%) and post-renal (10%) causes. Stage 1 AKI is the most common, but the progression to Stage 3 AKI is associated with significantly higher mortality (40%) and prolonged NICU stays.