DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20202882

Incidence of acute kidney injury in asphyxiated babies in university of Uyo teaching hospital, Uyo, Nigeria

Ikpeme Enobong Emmanuel, Dixonumo Ofonime Tony, Udoh Mary Paulinus, Udo Jacob J.

Abstract


Background: Acute Kidney Injury (AKI) is a consequence of birth asphyxia. In resource poor countries like ours, birth asphyxia still contributes to the high rates of neonatal morbidity and mortality. A few studies have reported the incidence of AKI in birth asphyxia in Nigeria but none from Uyo, south-south region of Nigeria.

Methods: A descriptive cross sectional study carried out in the Newborn Unit of the University of Uyo Teaching hospital, Uyo, Nigeria over a period of eight months. One hundred and four term neonates with provisional diagnosis of birth asphyxia using Apgar scoring were recruited. Blood sample was collected within six hours of life from each subject for serum creatinine estimation using modified Jaffe method. Urine output was assessed by application of plastic collection bag to the skin by adhesive patch. AKI was diagnosed when sCr >1.5mg/dl while oliguria was defined as urinary output <1.5ml/kg/hour.

Results: Of the total of 104 asphyxiated neonates enrolled into the study, 56 (53.8%) were males while 48 (46.2%) were females giving a male/female ratio of 1.2:1. Twenty-eight (26.9%) of the subjects had severe birth asphyxia; 52 (50%) had moderate birth asphyxia while 24 (23.1%) were mildly asphyxiated. Incidence of AKI was 48 (46.1%), twelve (11.5%) had AKI based on serum creatinine criteria while 36 (34.6%) had AKI based on urinary output criteria. The mean urinary output (ml/kg/hr) for the subjects was 1.65±0.68 while the mean serum creatinine (mg/dl) was 0.88±0.46.

Conclusions: The incidence of AKI among asphyxiated neonates in our locale is high at 46.1%.


Keywords


Acute kidney injury, Birth asphyxia, Incidence, Neonates

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References


Noto A, Cibecchini F, Fanos V, Mussap M. Neutrophil Gelatinase Associated Lipocalin and metabolomics: The single biomarker to reveal the metabolome alterations in kidney injury. Biomed Research Intl. 2013;10:1155-60.

Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure: definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8:204-12.

Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C. Acute Kidney Injury Network: Report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11:31.

The Kidney Disease Improving Global Outcomes (KDIGO) working group. Definition and Classification of Acute Kidney Injury. Kidney Int. 2012;2:19-36.

Bagshaw SM, George C, Bellomo R. Early acute kidney injury and sepsis: A multicenter evaluation. Crit Care. 2008;12:47.

Vachvanichsanong P, Dissoneewate P, Lim A, McNeil E. Childhood Acute Renal Failure: 22-year experience in University hospital in Thailand. Paediatr. 2006;118:e789-97.

Bailey D, Phan V, Littalien C, Ducruet T, Merouani A. Risk Factors of Acute Renal Failure in critically ill children: A prospective descriptive epidemiological study. Pediatr Crit Care. 2007;8:29-35.

Basu RK, Devarajan P, Wong H, Wheeler DS. An update and review of acute kidney injury in paediatrics. Pediatr Crit Care Med. 2011;12:339-47.

Schneider J, Khemani R, Grushkin C. Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in paediatric intensive care unit. Crit Care Med. 2010;38:933-9.

Assounga AG, Assambo-Kielle C, Nzingoula S. Etiology and outcome of Acute Renal Failure in children in Congo-Brazaville. Saudi J Kid Dis Transplant. 2000;11:40-3.

Katibi OS, Adedoyin OT, Anoba S, Sowunmi FO, Olorunsola BO, Ibrahim OR, et al. Current trends in the management of acute kidney injury in children. Niger J Paed. 2013;40(3):314-20.

Eke FU, Eke NN. Renal disorders in children: A Nigerian study. Paeditr Nephrol. 1994;8:383-6.

Abdurrhaman MB, Babaoye FA, Aikhionbare HA. Childhood renal disorders in Nigeria. Paediatr Nephrol. 1990;4:88-93.

Etuk IS, Anah MU, Ochigbo SO, Eyong M. Pattern of paediatric renal diseases in Calabar, Nigeria. Trop Doct. 2006;36:256-67.

Okoro BA, Okafor HU. Pattern of childhood renal disorders in Enugu. Niger J Paediatr. 1999;26:14-8.

Ikpeme EE, Dixon-Umo OT. Paediatric renal diseases in Uyo, Nigeria: a 10-year review. Afr J Paed Nephrol. 2014;1:12-7.

Adedoyin OT, Adesiyun OA, Mark F, Adeniyi A. Childhood renal disorders in Ilorin, north central Nigeria. Niger Postgrad Med J. 2012;19(2):88-91.

Ladapo TA, Esezobor CI, Lesi FE. Paediatric kidney diseases in an African country: prevalence, spectrum and outcome. Saudi J Kidney Dis Transplant. 2014; 25:1110-6.

Durkan AM, Alexander RT. Acute kidney injury post neonatal asphyxia. J Pediatr. 2011;158:29-33.

Andreoli SP. Acute renal failure in newborn. Semin Perinatol. 2004;28:112-23.

Agras PI, Tarcan A, Baskin E. Acute renal failure in neonatal period. Ren Fail. 2004;26:303-9.

Aggarwal AP, Kumar P, Chowdhary G, Majumdar S, Narang A. Evaluation of renal functions in asphyxiated newborns. J Trop Pediatr. 2005;51:295-9.

Airede AI, Bello M, Weerasinghe HD. Acute Renal Failure in the newborn: Incidence and outcome. J Pediatr Child Health. 1997;33:246-9.

Anochie IC, Eke FU. Acute renal failure in Nigerian children: Port Harcourt experience. Pediatr Nephrol. 2005;20:1610-4.

Akpan MU, Nyong EE. Pattern of admissions into the newborn unit of the University of Uyo Teaching Hospital, Nigeria. Int J Med Res Rev. 2017;5(9):851-6.

Ijezie E, Okpokowuruk FS. Mortality audit in the paediatrics department of the University of Uyo Teaching Hospital, Uyo, Nigeria. Int J Res Med Sci. 2016;4:615-20.

Ibe BC. Birth Asphyxia and Apgar scoring: A review. Nig Med Pract. 1990;20:111-3.

Ballard JL, Khoury JL, Wedig K, Wang L. New Ballard Score: expanded to include extremely premature infants. J Pediatr. 1991;119:417-23.

Lolekha PH, Jaruthunyaluck S, Srisawasdi P. Deproteinization of serum: Another best approach to eliminate all forms of bilirubin interference on serum creatinine by the kinetic Jaffe reaction. J Clin Lab Anal. 2001;15:116-21.

El-Raggal NM, Khafagy SM, Mahmoud NH, El-Beltagy SA. Serum neutrophil gelatinase-associated lipocalin as a marker of acute kidney injury in asphyxiated neonates. Indian Pediatr. 2013;50:459-62.

Aliyu I, Lawal TO, Onankpa B. Prevalence and outcome of perinatal asphyxia: our experience in a semi-urban setting. Trop J Med Res. 2017; 20(2):161-5.

Farghali OG, El-Raggal NM, Mahmoud NH, Zaria GA. Serum Neutrophil Gelatinase-Associated Lipocalin as a predictor of acute kidney injury in critically- ill neonates. Pak J Biol Sci. 2012;15(5):231-7.

Gupta BD, Sharma P, Bagla JY, Parakh M, Soni J. Renal failure in asphyxiated neonates. Indian Pediatr. 2005;42:928-34.

Devarajan P. Neutrophil Gelatinase-Associated Lipocalin: A promising biomarker for acute kidney injury. Biomark Med. 2010;4(2):265-80.

Xiao-yu L, Xin Z, Ying W, Jie D. Retrospective analysis of acute kidney injury in neonates with severe asphyxia. Chin J Evidence Based Pediatr. 2011;6:275-9.

Askenazi DJ, Ambalavanan N, Goldstein SL. Acute Kidney Injury in critically ill newborns: What do we know? What do we need to learn? Pediatr Nephrol. 2009;24:265-74.

Martin-Ancel A, Garcia-Alix A, Gaya F, Burgueros M, Quero J. Multiple organ involvement in perinatal asphyxia. J Pediatr. 1995;127(5):786-93.

Waikar SS, Betensky RA, Bonventre JV. Creatinine as gold standard for kidney injury biomarker studies. Nephrol Dial Transplant. 2009;24:3263-65.

Waikar SS, Bonventre JV. Creatinine kinetics and definition of Acute Kidney Injury. J Am Soc Nephrol. 2009;20:627-79.