Acute kidney injury in neonates who develop asphyxia at the time of delivery

Objective: To determine the frequency of acute kidney injury in neonates who develop asphyxia at delivery. Study Design: Cross-sectional study. Place and Duration of Study: Department of Paediatrics, Pak-Emirates Military Hospital, Rawalpindi Pakistan, Aug 2021 to Feb 2022. Methodology: This study was based on 69 patients diagnosed with birth asphyxia on the basis of APGAR score at 5 minutes. Patients underwent testing for serum creatinine levels at 24 hours post-delivery, as well as the monitoring of urine output, and acute kidney injury was classified according to the KDIGO classification, based on the increase in serum creatinine levels and urine output. Results: Acute kidney injury was observed in 12(17.4%) cases and 3(4.3%) neonates died. Lower gestational age at birth was associated with acute kidney injury (p=0.038), and acute kidney injury was associated with a higher chance for mortality (p<0.001). Additionally, male infants had a lower head circumference (p=0.001), a lower total body length (p<0.001) and a lower APGAR score at birth (p=0.004) when compared to females. However, they did not appear to have a higher risk for acute kidney injury (p=0.121). Conclusion: Acute kidney injury following the development of birth asphyxia is a common occurrence in our population efforts should be made to identify pregnancies at risk to mitigate this potentially devastating complication. (author)