Risk factors for acute neonatal renal failure

Authors

  • Setra H. Rambeloson Department of Pediatrics, University Hospital Center Mother and Child, Tsaralalana, Antananarivo, Madagascar
  • Christelle Samena Department of Pediatrics, University Hospital Center Mother and Child, Tsaralalana, Antananarivo, Madagascar
  • N. A. Rabevazaha Department of Pediatrics, University Hospital Center Mother and Child, Tsaralalana, Antananarivo, Madagascar
  • Elsa H. Rakotojoelimaria Department of Pediatrics, University Hospital Center Mother and Child, Tsaralalana, Antananarivo, Madagascar
  • Annick L. Robinson Department of Pediatrics, University Hospital Center Mother and Child, Tsaralalana, Antananarivo, Madagascar

DOI:

https://doi.org/10.18203/2349-3291.ijcp20222423

Keywords:

Acute neonatal renal failure, Perinatal asphyxia, Risk factors, Sepsis

Abstract

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=0.021, CI=1.56, 60.4), increased weight loss (OR=4.04, p=0.006, CI=1.51, 11.2) and respiratory distress (OR=2.76, p=0.005, CI=1.37, 5.77).

Conclusions: The risk factors were consistent with the data in the literature. Better management of parturients and the newborn as well as monitoring of serum creatinine in hospitalised newborns are recommended.

References

Marcher MA. Acute renal failure in children. Néphrology. 2007;18:10.

Askenazi DJ, Ambalavanan N, Goldstein SL. Acute kidney injury in critically ill newborns: what do we know? What do we need to learn? Pediatr Nephrol. 2009;24:265-74.

Selewski DT, Charlton JR, Jetton JG, Guillet R, Mhanna MJ, Askenazi DJ, et al. Neonatal Acute Kidney Injury. Pediatrics. 2015;136(2).

Andreoli SP. Acute kidney injury in children. Pediatr Nephrol. 2009;24:253-63.

Tóth-Heyn P, Drukker A, Guignard JP. The stressed neonatal kidney: from pathophysiology to clinical management of neonatal vasomotor nephropathy. Pediatr Nephrol. 2000;14:227-39.

Nada A, Bonachea EM, Askenazi D. Acute kidney injury in the fetus and neonate. Semin Fetal Neonatal Med. 2017;22(2):90-7.

Bitsori M. The development of renal function. Essentials in Pediatric Urol. 2012;9-20.

Bakr A, Eid R, Allam NA, Saleh H. Neonatal Acute Kidney Injury: Diagnostic and Therapeutic Challenges. J Nephrol Res. 2018;4(1):130-4.

Chua AN, MD, Sarwal MM. Acute Renal Failure Management in the Neonate. Neo Rev. 2005;6(8).

Yenidoğan ABH, Adil UZ, Bülbül A, Uslu HS. Neonatal Acute Kidney Injury. JAREM. 2013;3:53-9.

Jetton JG, Askenazi DJ. Update on acute kidney injury in the neonate. Curr Opin Pediatr. 2012;24(2):191-6.

Cataldi L, Leone R, Moretti U, Mitri BD, Fanos V, Ruggeri L, et al. Potential risk factors for the development of acute renal failure in preterm newborn infants: a case-control study. Arch Dis Child Fetal Neonatal. 2005;90:514–9.

Ottonello G, Dessì A, Neroni P, Trudu EM, Manus D, Fanos V. Acute kidney injury in neonatal age. J Pediatric Neonat Individualized Med. 2014;3(2).

Pandey V, Kumar D, Vijayaraghavan P, Chaturvedi T, Raina R. Non-dialytic management of acute kidney injury in Newborns. J Renal Inj Prev. 2017;6(1):1-11.

Mortazavi F, Sakha HS, Nejati N. Acute Kidney Failure in Neonatal Period. IJKD. 2009;3:136-40.

Momtaz HE, Sabzehei MK, Rasuli B, Torabian S. The Main Etiologies of Acute Kidney Injury in the Newborns hospitalized in the Neonatal Intensive Care Unit. J Clin Neonat. 2014;3(2).

Azat NFA, Salih AA, Naoom MB. Iraqi Postgrad Med J. 2011;10(2).

Doaa Y, HAbd-Elrahman H, Shehab MM, Abd-Elrheem M. Incidence of Acute Kidney Injury in the Neonatal Intensive Care Unit. Saudi J Kidney Dis Transpl. 2015;26(1):67-72.

Agras PI, Tarcan A, Baskin E, Cengiz N, Gürakan B, Saatci U. Acute Renal Failure in the Neonatal Period. Renal Failure. 2004;26(3):305-9.

Naveed B, Munir S, Ashraf N, Zahid M, Rubab T. Neonatal Acute Renal Failure: Predisposing Factors and Their Outcome. Experience from a Tertiary Care Hospital. Ann Pak Inst Med Sci. 2016;12(2):90-3.

Satvik CB, Nimbalkar AS, Kungwani AR, Patel DV, Sethi AR, Nimbalkar SM. Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India. J Clin Diagnostic Res. 2017;11(3):SC01-4.

Halder S, Hoque MM, Rahman U, Sonia SF, Biswas SS. Acute Kidney Injury in Sick Neonate: Incidence and Outcome. J Bangladesh Coll Phys Surg. 2017;35:20-3.

Zulic E, Devleta H. Acute renal failure in the newborns hospitalized at the intensive care unit, university clinical centre tuzla. Sanamed. 2015;10(1):47-50.

Libório AB, Branco KMPC, Bezerra CT. Acute Kidney Injury in Neonates: From Urine Output to New Biomarkers. BioMed Res Int. 2014;601568.

Nali MA, Rehman A, Ahmed E. Association of In-hospital outcome of Acute Kidney Injury (AKI) with etiology among newborns at a tertiary care unit. Pak J Med Sci. 2018;34(1):125-9.

Simunek VZ. Definition of intrapartum asphyxia and effects on outcome. Midwifery Rev. 2008;7:79-86.

Coulibaly G, Ouédraogo-Yugbaré SO, Kouéta F, Yao LS, Savadogo H, Dao L, et al. Perinatalasphyxia and acute renal insufficiency in Ouagadougou. Arch Pediatrics. 201;23(3):249-54.

Nouri S, Beizig MS, Zakhama R, Salem N, Ben Dhafer S, Methlouthi J, et al. Acute renal failure in full term neonates with perinatal asphyxia. Prospective study of 87 cases. Arch Pediatrics. 2008;15:229-35.

Société française de néonatalogie. Prise en charge du nouveau-né à risque d’infection néonatale bactérienne précoce (≥34 SA) Méthode Recommandations pour la pratique clinique. Argumentaire scientifique. 2017. Available at: http://www.has0sante.fr/portail/jcms/c_431294/recommandations-pour-la-pratique-clinique-rpc. Accessed on 05 May 2022.

Ghobrial EE, Elhouchi SZ, Sarah S, Eltatawy SS, Beshara LO. Risk Factors Associated with Acute Kidney Injury in Newborns. Saudi J Kidney Dis Transpl. 2018;29(1):81-7.

Mathur NB, Agarwal HS, Maria A. Acute Renal Failure in Neonatal Sepsis. Indian J Pediatr. 2006;73(6):499-502.

Jagrawal G, Arora V, Gunawat M, Malik P. Acute renal failure in neonatal septicemia. IJBR. 2016;7(5):260-4.

Holda AM, Mehariy KM, Patel P, Patel P. Study of Effect of Neonatal Septicemia on Renal Function. IJSR. 2014;3(12):2319-7064.

Nillse A, Kent AL. Sepsis and Neonatal Acute Kidney Injury. J Pediatr Infect Dis. 2016;11(3):55-64.

Gomez H, Ince MC, De Backer D, Pickkers P, Payen D, Hotchkiss J, et al. A Unified Theory of Sepsis-Induced Acute Kidney Injury: Inflammation, microcirculatory dysfunction, bioenergetics and the tubular cell adaptation to injury. Shock. 2014;41(1):3-11.

Honore PM, Jacobs R, Hendrickx I, Bagshaw S M, Joannes Boyau O, Boer W, et al. Prevention and treatment of sepsis-induced acute kidney injury: an update. Ann Intensive Care. 2015;5:51.

Gupta B D, Sharma P, Bagla J, Parakh M, Soni JP. Renal Failure in Asphyxiated Neonates. Indian Pediatrics. 2005;928(42).

Alaro D, Bashir A, Musoke R, Wanaiana L. Prevalence and outcomes of acute kidney injury in term neonates with perinatal asphyxia. Afr Health Sci. 2014;14(3).

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Published

2022-09-26

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Original Research Articles