Abstract
Objective This study aims to determine the proportion of cases of neonatal sepsis developing
acute kidney injury (AKI).
Methods This is a prospective observational study conducted in the nursery of a tertiary
care center in Northern India during October 2012 to March 2014. Newborns with symptoms
suggestive of sepsis were investigated. Those with congenital renal anomalies and
negative for sepsis were excluded from the study. Newborns with sepsis were treated
accordingly and observed for AKI until discharge or death. Acute Kidney Injury Network
definition was used to define AKI in this study.
Results A total of 310 neonates with sepsis were enrolled out of which 3.87% neonates developed
AKI. Factors such as maternal age, sex, birth weight, gestational age, asphyxia, the
risk factor of sepsis in the mother, meconium-stained liquor, and mode of delivery
were not found to be associated with AKI. Meningitis (p < 0.05) was found to be significantly associated with AKI. Duration of stay was longer
for those with AKI (p < 0.01), but the mortality rate did not differ significantly among those with AKI
and those without AKI. Around 25% of cases were found to be AKI stage 1, 25% of cases
were AKI stage 2, and 50% of cases were AKI stage 3.
Conclusion It is difficult to predict AKI based on clinical features, so it is better to screen
all the neonates with sepsis for AKI so that they can be managed accordingly, as AKI
detected early has a better prognosis.
Keywords
acute kidney injury - neonatal sepsis - multiorgan - dysfunction syndrome
