Predictive Factors for Acute Renal Failure in Neonates with Septicemia

Objectives: Septicemia is an important cause of acute kidney injury (AKI) in neonates admitted to neonatal intensive care units. The aim of this study was to identify the predictive factors for AKI in neonates with culture-proven septicemia. Methods: Medical records of 138 newborns with septicemia were evaluated in 2 groups with (n, 65) and without (n, 73) AKI. Results: The mean age at diagnosis of AKI was 11.319.92 days. AKI was more common in neonates with lower gestational age, birth weight, age, blood pressure, platelet count, and serumpHat admission. Moreover, AKI was associated with an increased incidence of intubation at birth, inotrope treatment, shock, disseminated intravascular coagulation (DIC), mechanical ventilation, and morality. Gestational age, initial serum pH, and DIC were the only independent predictors of AKI in the multivariate analysis. In addition, serum pH at admission was the most accurate laboratory marker for the prediction of AKI with 83% sensitivity and 60% specificity. Conclusions: Monitoring of renal function is highly recommended in low-birth-weight infants with severe septicemia.