Acute Kidney Injury in Neonates Admitted to a Low-Resource Neonatal Intensive Care Unit in Lusaka, Zambia.

IF 1.6 Q3 UROLOGY & NEPHROLOGY

Canadian Journal of Kidney Health and Disease Pub Date : 2024-07-25 eCollection Date: 2024-01-01 DOI:10.1177/20543581241263160

Mavis Chishala, Sylvia Machona-Muyunda, Chisambo Mwaba

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引用次数: 0

Abstract

Background: Neonatal acute kidney injury (nAKI) has been reported to be common among neonates admitted to the Neonatal Intensive Care Unit (NICU) and is associated with increased mortality and prolonged duration of hospital stay. However, data on this entity from sub-Saharan Africa are scanty.

Objectives: This study aimed to assess the burden, risk factors, and short-term outcomes of nAKI in neonates admitted to a low-resource NICU in Zambia.

Design: The design of the study is a prospective cohort study.

Setting: The setting of this study was the NICU at the Women and Newborn Hospital of the University Teaching Hospitals (WNBH-UTHs).

Patients: In total, 322 neonates who were admitted to the NICU between November 2021 and December 2022.

Methods: A serum creatinine was determined on all patients at admission (within 24 hours), at 72 hours and day 7. The modified neonatal Kidney Disease: Improving Global Outcome (KDIGO) Criteria were used to define nAKI. Data were extracted using a predesigned form and analyzed using SPSS. A P-value less than .05 was considered statistically significant.

Results: The prevalence of nAKI was 13.7% (44/322). On multivariable regression analysis, antepartum hemorrhage (adjusted odds ratio [AOR] 5.58; 95% confidence interval [CI]: [1.62-19.13], P = .007), vomiting in the neonate (AOR 5.76; 95% CI: [1.10-30.32], P = .04), history of use of unit second-line antibiotics, meropenem (AOR 4.37; 95% CI: [1.97-9.69], P < .001), and ciprofloxacin (AOR 4.53; 95% CI: [1.22-16.84], P = .02) were associated with increased risk of nAKI. Acute kidney injury (AKI) was significantly associated with longer length of hospital stay and higher mortality (P < .05).

Limitations: The study did not use the urine output criteria to define nAKI and this may have led to an underestimation of nAKI prevalence. Additionally, kidney, ureter, and bladder ultrasound was not performed on any of the study participants.

Conclusion: AKI is common in neonates admitted to the NICU at WNBH-UTHs, and it is associated with a higher risk of mortality and prolonged length of hospital stay. Further studies among the various NICU sub-populations are needed to better characterize risks and outcomes.

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赞比亚卢萨卡一家资源匮乏的新生儿重症监护室收治的新生儿急性肾损伤。

背景：据报道，新生儿急性肾损伤（NAKI）在新生儿重症监护室（NICU）收治的新生儿中很常见，与死亡率增加和住院时间延长有关。然而，撒哈拉以南非洲地区有关该疾病的数据却很少：本研究旨在评估赞比亚一家资源匮乏的新生儿重症监护室收治的新生儿患纳克病的负担、风险因素和短期疗效：研究设计为前瞻性队列研究：研究地点：大学教学医院妇女和新生儿医院（WNBH-UTHs）的新生儿重症监护室：患者：2021年11月至2022年12月期间入住新生儿重症监护室的322名新生儿：所有患者在入院时（24 小时内）、72 小时和第 7 天均测定了血清肌酐。方法：对所有患者在入院时（24 小时内）、72 小时和第 7 天进行血清肌酐测定：改善总体预后 (KDIGO) 标准来定义 nAKI。使用预先设计的表格提取数据，并使用 SPSS 进行分析。P值小于0.05为具有统计学意义：nAKI 的发生率为 13.7%（44/322）。经多变量回归分析，产前出血（调整赔率[AOR]5.58；95% 置信区间[CI]：[1.62-19.13]，P = .007）、新生儿呕吐（AOR 5.76；95% CI：[1.10-30.32]，P = .04）、二线抗生素美罗培南使用史（AOR 4.37；95% CI：[1.97-9.69]，P = .02）与发生 nAKI 的风险增加有关。急性肾损伤（AKI）与住院时间延长和死亡率升高密切相关（P 限制：该研究没有使用尿量标准来定义 nAKI，这可能导致 nAKI 发生率被低估。此外，没有对任何研究参与者进行肾脏、输尿管和膀胱超声检查：结论：AKI在西北卡罗来纳州立大学附属医院新生儿重症监护室收治的新生儿中很常见，它与较高的死亡风险和较长的住院时间有关。需要对新生儿重症监护病房的不同亚群进行进一步研究，以更好地确定风险和结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian Journal of Kidney Health and Disease Medicine-Nephrology

CiteScore

3.00

自引率

5.90%

发文量

审稿时长

12 weeks

期刊介绍： Canadian Journal of Kidney Health and Disease, the official journal of the Canadian Society of Nephrology, is an open access, peer-reviewed online journal that encourages high quality submissions focused on clinical, translational and health services delivery research in the field of chronic kidney disease, dialysis, kidney transplantation and organ donation. Our mandate is to promote and advocate for kidney health as it impacts national and international communities. Basic science, translational studies and clinical studies will be peer reviewed and processed by an Editorial Board comprised of geographically diverse Canadian and international nephrologists, internists and allied health professionals; this Editorial Board is mandated to ensure highest quality publications.