Sreelekha Palle1 , Kavitha Shanigaram2 , Raghava Polanki3
BACKGROUND Sepsis remains as a leading cause of morbidity and mortality among neonates. The present study was undertaken with the objective of evaluating occurrence of AKI in neonatal sepsis using AKIN criteria, associated risk factors and outcome. METHODS The study was conducted in the NICU of Niloufer Hospital, Hyderabad, India. The present study is a retrospective cohort study. Medical records of 200 cases of neonates with sepsis admitted from October 2019 to March 2020 were studied. Neonatal sepsis was diagnosed on the basis of either a positive sepsis screen or a positive blood culture in symptomatic neonates. The sepsis screen was positive if 2 or more of the following were present - CRP >1 mg/dL; micro-ESR > age in days + 2 mm or > 15 mm fall in first hour; total leucocyte count 15000/mm3 , immature: total neutrophil ratio >0.2. Acute renal failure (ARF) was defined as per AKIN criteria. RESULTS 13 out of 200 (6.5%) neonates with sepsis had AKI; 3 babies (23.07%) were in oliguric AKI and 10 (76.92%) babies were in non-oliguric AKI. The presence of shock and DIC was found to be a significant risk factor for AKI. CONCLUSIONS Incidence and mortality associated with AKI in sepsis was found to be 6.5% and 30.76% respectively. The high mortality among septicaemic neonates with AKI stresses the need for neonates-with-sepsis to be screened for renal failure, as early recognition of coexisting risk factors for AKI may reduce the risk of its occurrence and early intervention can lead to better outcome.
