Factors of Acute Kidney Injury in Newborns with Postnatal Asphyxia

Acute kidney injury (AKI) is a significant complication in neonates with postnatal asphyxia due to renal vulnerability to hypoperfusion and ischemic injury. This cross-sectional study aimed to determine the frequency and associated factors of AKI in asphyxiated newborns admitted to the Department of Pediatrics, Bacha Khan Medical Complex, Swabi. A total of 112 neonates aged 1–60 days with AKI secondary to postnatal asphyxia were enrolled using non-probability consecutive sampling. Clinical factors including hypotension, mechanical ventilation, and hypoxic-ischemic encephalopathy (HIE) were assessed. The mean age of participants was 18.4 ± 12.6 days, and mean weight was 2.6 ± 0.7 kg. Males accounted for 59.8% of cases. Hypotension was observed in 36.6% of neonates, mechanical ventilation was required in 30.4%, and HIE was diagnosed in 25.9%. Stratified analysis revealed a significant association between hypotension and lower socioeconomic status (p = 0.041) and between HIE and male gender (p = 0.032). No significant associations were found with maternal occupation or residence. These findings highlight hypotension, ventilatory support, and HIE as the leading contributors to AKI in neonates with postnatal asphyxia. Recognition of these risk factors is critical for early screening, timely intervention, and prevention of renal morbidity. This study emphasizes the importance of improved neonatal care, especially in resource-limited settings, to mitigate AKI-related complications and enhance survival outcomes.