ABSTRACT
Background: Acute kidney injury (AKI) is a clinical conditionoften seen in the neonatal intensive care units. The incidenceof AKI in neonates treated at the NICU ranges from 2.4 to 56%. Many etiological factors predispose development of AKI inneonates. AKI has a significant impact on survival rates,especially in preterm infants and Neonates with AKI have veryhigh mortality rates (4.5–78 %). Our understanding of AKI inLBW newborns is mostly limited to retrospective studies. So weplanned a prospective study in preterm babies with AKIdiagnosed by Koralkar criteria.Objectives: To find proportion of preterm babies (<37 weeksof gestation) with acute kidney injury born in the hospitals andto find out demographics, co-morbidities, clinical presentation,risk factors, and outcome in preterm newborns with AKI.Materials & Methods: A Prospective study on 215 pretermbabies was conducted at Neonatal units attached to SMSMedical College, Jaipur during Feb 2015 to March 2017. Thestudy variables were analyzed using Epi-Info7 software withapplication of Mean, Proportion, Chi-square, t- test, regressionanalysis and Kaplan-Meier Survival analysis.Results and Conclusion: Out of 215 pre-term infants 36(16.7%) had AKI with maximum patients in cat.1 (11.1%). Outof 36 preterm infants with AKI 13 died and no statisticallysignificant association was found between AKI and mortalityamong preterm infants. Statistically significant association wasfound between birth weight, sepsis, HMD, MV, NEC andmortality among preterm infants. Logistic regression wasperformed to eliminate potential confounders. Our final modelincluded variables with p<0.10. After regression analysis onlybirth weight was associated with mortality among preterminfants with p=0.028. On comparing survival among pretermwith AKI and without AKI the Average Hazard Rate was moreamong preterm infants with AKI but on applying Log Rank Testno statistically significant difference was found between thesurvival probabilities of the two groups.