Acute renal failure SNAPPE and mortality (original) (raw)
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Risk factors for acute neonatal renal failure
International Journal of Contemporary Pediatrics
Background: Acute neonatal renal failure is a health problem. Its risk factors and its clinical and evolutionary profile remain unknown in the Malagasy context. The main objective of this study was to determine its risk factors.Methods: This was a 14 month, single-center, retrospective, case-control study (November 2018 to December 2019). The cases were represented by newborns hospitalized and presenting an hypercreatininaemia (value >133 µmol/l or according to the KDIGO criteria) and controls by neonates without an hypercreatininaemia. One case was matched to 2 controls.Results: We included 75 cases. The prevalence was 14.5%. The mean age was 5±6.78 days (p=0.006). The sex ratio was 1.27. The mean gestational age was 36.69±3.84 WA (p=0.66). The mean serum creatinine value was 180.32 µmol/l. Thirty-one newborns had died (41.3%). The risk factors were: sepsis (OR=9.37, p≤0.001, CI=3.03, 33.5), perinatal asphyxia SARNAT 2 (OR=4.52, p=0.007, CI=1.53, 13.8) and SARNAT 3 (OR=7.90, p=0...
Iranian journal of pediatrics, 2013
To evaluate the incidence, etiology, outcome, and predictors of mortality in neonates with Acute Renal Failure (ARF) in an out born Neonatal Intensive Care Unit (NICU) of India. A retrospective analysis of case records of out born neonates, who had ARF at admission or developed ARF during NICU stay, from January to December 2011 (one year) was done. Out of the total 456 neonates admitted during the study period, 44 (9.6%) neonates with ARF (32 males, 12 females) were studied. Their mean gestational age, weight, and age at admission was 34.7±3.9 weeks, 2100±630 grams, and 2.1±6.3 respectively. Causes of ARF were pre-renal in 22 (50%), intrinsic renal failure in 16 (36.3%), and post-renal in six (13.6%). Oliguria was present in 29 neonates. Neonatal sepsis was the commonest cause of ARF, followed by perinatal asphyxia, respiratory distress syndrome, and genitourinary anomalies. ARF was present at admission in 37 neonates. The mortality rate was 15.9% (7/44). Thirty-seven (84%) were di...
Acute kidney injury in premature newborns—definition, etiology, and outcome
Pediatric Nephrology, 2017
Background Neonatal acute kidney injury (AKI) is common and is associated with poor outcomes. New criteria for the diagnosis of AKI were introduced based on the increase in serum creatinine (SCr) levels and/or reduction of urine output (UOP). Yet, there is no generally accepted opinion so far, which criteria (whether SCr, UOP, or their combination) are the most appropriate to diagnose neonatal AKI. Methods The retrospective study included 195 prematurely born neonates who fulfilled all inclusion criteria (with at least two SCr measurements). In all the neonates included in the study, AKI was diagnosed using three different definitions: (1) SCr criteria (an increase in SCr values of ≥0.3 mg/dl), (2) UOP criteria (UOP < 1.5 ml/kg/h), and (3) SCr + UOP criteria. Results Out of all of the patients the study included, 85 (44%) were diagnosed with AKI. The neonates who had AKI had a significantly lower gestational age, birth weight, and Apgar score, longer duration of mechanical ventilation, and a higher mortality rate. SCr + UOP criteria showed higher sensitivity for prediction of death compared to SCr or UOP alone (p = 0.0008, 95% CI 0.040-0.154, and p = 0.0038, 95% CI 0.024-0.125, respectively). If only SCr or only UOP criterion are used, they fail to identify AKI in 61 and 67%, respectively. AKI was an independent risk factor for death (OR 7.4875; CI 3.1887-17.5816). Conclusions Similar to other studies, our data showed that neonates with AKI have worse outcome. Neonatal AKI defined based on SCr + UOP criteria is a better predictor of death than neonatal AKI defined based only on the SCr or UOP criteria. Also, by using SCr + UOP criteria for diagnosing neonatal AKI, more patients with AKI are recruited than when only one of those criteria is used.
Acute renal failure in the newborn: Incidence and outcome.
Objective: To describe an experience from a developing country of newborn renal disease particularly those without advanced neonatal care. Methodology: Prospective evaluation from a referral hospital, North-East of Nigeria between 1 July 1990 and 30 June 1994.
Risk factors and mortality rate in premature babies with acute kidney injury
Journal of clinical laboratory analysis, 2018
Acute kidney injury (AKI) is a common morbidity in neonatal intensive care units and associated with poor outcome. This study aimed to determine the prevalence of AKI and provide a demographic data and risk factors associated with the mortality and morbidity. This is a retrospective study included 105 premature babies. Diagnosis of AKI was based on neonatal KDIGO classification criteria. The babies were stratified into two groups according to AKI status during the hospitalization. Clinical and laboratory characteristics of the AKI group were compared to non-AKI group. AKI occurred in 21 (20.0%) of 105 premature babies, and mortality rate in these babies was 61.9%. Lower gestational weeks, lower Apgar scores at 5 minutes, lower systolic blood pressures, and inotropic supports were independent risk factors for the development of AKI in preterm babies (P < .05, for each). Oliguria, preeclampsia/eclampsia, resuscitation at birth, lower diastolic blood pressure, patent ductus arterios...
Risk Factors Associated with Acute Renal Failure in Neonates of a neonatal Intensive Care Unit
Asian Journal of Pediatric Research
Objetive: Determining the risk factors associated with acute renal failure in neonates. Materials and Methods: A case-control study was carried out, in 65 cases of acute renal failure and 65 without acute renal failure in the Intensive Care Unit Neonatals (NICU) of a hospital in Pachuca Hidalgo, Mexico. The variables studied; prematurity, low weight, type I respiratory distress syndrome, perinatal asphyxia, sepsis, necrotizing enterocolitis, administration of vancomycin, amikacin, amphotericin, cefotaxime and water restriction. The information was collected from the data of the clinical records and the analysis was carried out in the Epi-info software. The statistical analysis, it was performed using non-parametric tests such as Chi2 and Fisher's Exact Test. Results: Denote underweight with an OR 2, 95% CI. from 1.1 to 3.3 and
Late onset neonatal acute kidney injury: results from the AWAKEN Study
Pediatric Research, 2018
on behalf of the Neonatal Kidney Collaborative (NKC) BACKGROUND: Most studies of neonatal acute kidney injury (AKI) have focused on the first week following birth. Here, we determined the outcomes and risk factors for late AKI (>7d). METHODS: The international AWAKEN study examined AKI in neonates admitted to an intensive care unit. Late AKI was defined as occurring >7 days after birth according to the KDIGO criteria. Models were constructed to assess the association between late AKI and death or length of stay. Unadjusted and adjusted odds for late AKI were calculated for each perinatal factor. RESULTS: Late AKI occurred in 202/2152 (9%) of enrolled neonates. After adjustment, infants with late AKI had higher odds of death (aOR:2.1, p = 0.02) and longer length of stay (parameter estimate: 21.9, p < 0.001). Risk factors included intubation, oligo-and polyhydramnios, mild-moderate renal anomalies, admission diagnoses of congenital heart disease, necrotizing enterocolitis, surgical need, exposure to diuretics, vasopressors, and NSAIDs, discharge diagnoses of patent ductus arteriosus, necrotizing enterocolitis, sepsis, and urinary tract infection. CONCLUSIONS: Late AKI is common, independently associated with poor short-term outcomes and associated with unique risk factors. These should guide the development of protocols to screen for AKI and research to improve prevention strategies to mitigate the consequences of late AKI.
Prognostic Factors and Mortality Rate in Neonates with Acute Renal Injury in NICU
Introduction: 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. 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. Conclusions: 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.
The spectrum of onset of acute kidney injury in premature infants less than 30 weeks gestation
Journal of Perinatology, 2016
To determine risk factors for acute kidney injury (AKI) in preterm infants as a function of time of onset. STUDY DESIGN: In this 5 1/2-year, single-center, retrospective study, incidence and timing of AKI was determined using modified Acute Kidney Injury Network criteria. Characteristics of newborns with and without AKI were compared by chi square and t-tests. Logistic regression was used to examine risk factors for AKI as a function of time of onset and potential confounders. RESULT: AKI occurred in 30.3% of 357 neonates; 72.2% was stage 1. Gestational ages (GA), initial Cr, maternal magnesium and volume resuscitation were associated with early AKI (days 0 to 1). Volume resuscitation, umbilical arterial line and receipt of non-steroidal anti-inflammatory drug (NSAID) for patent ductus arteriosus were associated with intermediate AKI (days 2 to 5). GA, steroids for early hypotension, necrotizing enterocolitis and sepsis were associated with late AKI (⩾ day 6). CONCLUSION: Stage 1 AKI is a common morbidity in our population. Risk factors for AKI in our population differed with time of onset.
Incidence, risk factors, and outcome of neonatal acute kidney injury: a prospective cohort study
Pediatric nephrology (Berlin, Germany), 2018
Acute kidney injury (AKI) is common in neonates admitted to the neonatal intensive care unit (NICU). AKI is associated with increased morbidity and mortality and a greater long-term risk of chronic kidney disease. To study the incidence and outcome of neonatal AKI in a single Saudi Arabian center, level 2\3 NICU. This single-center prospective cohort study included all infants who received level II or III NICU care during 2015 (January to December). We excluded infants who survived less than 48 h after admission, had evidence of congenital renal anomalies, or had insufficient data. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Both AKI and non-AKI neonates were prospectively followed up until NICU discharge. Outcomes studied included mortality and length of NICU stay. The results of adjusted risk analyses were expressed as relative risk (RR) with 95% confidence interval (95% CI). The incidence of AKI (modified neonatal KDIGO stages) was...