Publication: Acute Kidney Injury in Neonates with Perinatal Asphyxia in a Tertiary Care Hospital of Nepal: a cross-sectional study
Date
2025
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Renal involvement is the most common form of systemic complication in neonates
with perinatal asphyxia. Acute Kidney Injury (AKI) can be oliguric or non oliguric.
There is no consensus on the definition of acute kidney injury in neonates, which
makes early diagnosis and management difficult. Acute kidney injury leads to
significant morbidity and mortality in neonates.
Objective
Current study aims to explore the prevalence of Acute Kidney Injury in Neonates with
perinatal asphyxia and its relation to the severity of Hypoxic Ischemic Encephalopathy
(HIE).
Method
A single-center, retrospective, cross-sectional study was carried out to analyze the
cases of perinatal asphyxia in the Neonatal Intensive Care Unit (NICU) and Neonatal
Ward (NNW) for a period of three years (September 2020 to August 2023) in a tertiary
care center. The study analyzed 195 neonates with perinatal asphyxia and Hypoxic
Ischemic Encephalopathy (HIE). Data analysis was done using Statistical Package for
Social Sciences (SPSS) version 25. Descriptive statistics(mean ± SD for continuous
variables; percentages for categorical variables) and chi-square test (to compare
categorical associations) were applied. The prevalence of acute kidney injury and its
relation to grades of HIE were determined using a chi-square test.
Result
The prevalence of acute kidney injury among cases of perinatal asphyxia was 17.4%.
The prevalence of acute kidney injury increased with an increase in the grading of
hypoxic ischemic encephalopathy. Acute kidney injury was predominant among
males with a male-to-female ratio being 3.2:1. Oliguric acute kidney injury was
more common than non-oliguric acute kidney injury. 8.8% of cases had mortality,
with the majority of cases being hypoxic ischemic encephalopathy grade II. The Chi-
square test found a statistically significant association between hypoxic ischemic
encephalopathy grades and acute kidney injury (p value=0.0113, i.e., p < 0.05)
Conclusion
Acute kidney injury remains one of the common complications of Perinatal Asphyxia
(PA). There was a significant association between acute kidney injury cases and grades
of Hypoxic Ischemic Encephalopathy (HIE), with HIE II being the most common type.
Screening for acute kidney injury in case of hypoxic ischemic encephalopathy should
be prioritized.
KEY WORDS
Acute kidney injury, Birth asphyxia, Oliguria, Perinatal asphyxia
Description
Gautam S, Gautam P, Chaudhary A, Dahal A, Manandhar A, Giri P, Dulal A, Pokhrel S
Department of Pediatrics
Dhulikhel Hospital, Kathmandu University Hospital
Kathmandu University School of Medical Sciences
Dhulikhel, Kavre, Nepal
Keywords
Acute kidney injury, Birth asphyxia, Oliguria, Perinatal asphyxia