Evaluation of risk factors and outcomes of neonates with hypoxic ischemic encephalopathy and acute kidney injury

Abstract

To assess risk factors for acute kidney injury (AKI) in neonates with hypoxic ischemic encephalopathy (HIE) using KDIGO and Gupta definitions, and evaluate long-term kidney function. Retrospective study including 72 neonates with HIE and prospective evaluation of long-term kidney health data of 33 survivors. AKI was detected in 49% using KDIGO and 32% using Gupta’s definition. KDIGO-defined AKI correlated with thrombocytopenia, low pH, transfusions need, nephrotoxic drugs, and furosemide use (p < 0.05). The Gupta definition showed additional associations with hypotension, cardiac dysfunction, and death (p < 0.05). In a logistic regression model, both definitions linked AKI to nephrotoxic drug exposure and transfusions. Follow-up assessments revealed elevated blood pressure in 12%, hyperfiltration in 18%, and proteinuria in 6% of survivors. The Gupta definition may help identify AKI in an additional number of neonates with HIE. Long-term monitoring is essential for the early detection of kidney dysfunction.