Acute Kidney Injury in Neonatal Sepsis: Risk Factors, Clinical Profile, and Outcome

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 fromthe 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.