PROGNOSTIC FACTORS AND MORTALITY RATE IN NEONATES WITH ACUTE RENAL INJURY IN NICU

How to Cite This Article: Esfandiar N, MohkamM, Afjeii A, et al. Prognostic Factors and Mortality Rate in Neonates with Acute Renal Injury in NICU. J Ped. Nephrology 2013 July;1(1):32-36. Background: Acute Renal Injury (AKI) is a frequent clinical condition in the Neonatal Intensive Care Units (NICUs). Most AKI causes are preventable; performing rapid preventive, diagnostic, and therapeutic measures could prevent the potential complications. Aim: The present study was conducted to define the risk factors and mortality rates of neonates with and without AKI admitted in the NICU of a tertiary care hospital. Materials and methods: Demographic and biochemical data of NICU of Mahdieh Hospital were collected and analyzed. More than twofold increase in normal serum creatinine level or > 0.8 mg/dl (for infants > 4 days age) was defined as AKI. All newborns were divided into two groups: with and without AKI. Risk factors and mortality rates were compared in the 2 groups. Results: The mortality rate of newborns with AKI was 4.5%. The other risk factors for mortality in neonates with AKI were as follows: Hyaline Membrane Disease (HMD) (P < 0.03), using mechanical ventilation (P < 0.041), using surfactant (P < 0.04), first minute Apgar score < 5, PCO2 > 60 mmHg (P < 0.035), birth weight < 2500 g (P < 0.003) and serum creatinine (SCr) level > 1 mg/dl (P < 0.003). ROC Curve revealed that low birth weight was the most significant risk factor for mortality of neonates with AKI admitted in the NICU. Conclusion: Mortality related to AKI was associated with HMD, using mechanical ventilation, the need to surfactant use, low Apgar score, high blood PCO2, high serum creatinine level, and low birth weight.