A Hospital-Based Study on the Prevalence and Determinants of Acute Kidney Injury in Neonates Diagnosed with Hypoxic-Ischemic Birth Asphyxia
Submission: 21 January 2025 | Acceptance: 19 March 2025 | Publication: 21 May 2026
1Irfan Safdar, 2Dr. Sehrish Khan, 1Javed Butt, 1Umar Ali, 1Mohib Ali, 1Ali Raza
1BBH, Rawalpindi, 2Assistant professor, Paediatrics, CMH Muzaffrabad
ABSTRACT:
Background: Early recognition and management are critical to improving outcomes. Acute kidney injury (AKI) is a significant complication in neonates with birth asphyxia, contributing to increased morbidity and mortality.
Aim: This study aimed to determine the prevalence of acute kidney injury in neonates with birth asphyxia and identify associated risk factors.
Method: The study included 50 neonates diagnosed with birth asphyxia, defined by Apgar scores ≤5 at 5 minutes of life or evidence of hypoxic-ischemic encephalopathy. This descriptive cross-sectional study was conducted at Mayo Hospital, Lahore, from July 2023 to July 2024. AKI was diagnosed based on serum creatinine levels and urine output criteria as per the KDIGO guidelines. Data on demographics, clinical characteristics, and laboratory findings were collected and analyzed using statistical software.
Results: The prevalence of AKI among neonates with birth asphyxia was found to be 42% (21 out of 50 neonates). Most cases were classified as stage 1 AKI (67%), followed by stage 2 (24%) and stage 3 (9%). Factors significantly associated with AKI included low Apgar scores (p<0.05), prolonged resuscitation time (p<0.01), and the presence of hypoxic-ischemic encephalopathy (p<0.01). Neonates with AKI had longer hospital stays and required more intensive care support than those without AKI.
Conclusion: Acute kidney injury is a common complication in neonates with birth asphyxia, highlighting the need for routine screening and prompt management. Identifying high-risk neonates based on clinical and biochemical parameters is crucial to improving neonatal outcomes in this population.
Keywords: Acute kidney injury, birth asphyxia, neonates, prevalence, risk factors, hypoxic-ischemic encephalopathy.