Deranged kidney function in neonates in Kano: a cause for concern

Abstract

Background: In neonates, derangement in kidney function on admission is often overlooked, especially in resource-constrained settings, and is associated with increased risk of morbidity and mortality. This study aimed to describe the burden of acute kidney injury (AKI) in neonates admitted to a tertiary hospital in northern Nigeria.

Methods: The laboratory results of serum electrolytes, urea and creatinine of all neonates aged 5 days and over admitted into the newborn unit over a period of six months were retrospectively reviewed and values compared with neonatal reference ranges. The age and sex of each neonate were recorded. Results of repeat samples and those without age and/or sex indicated were excluded. Kidney function was classified based on the degree of rise in serum creatinine relative to normal values.

Results: The results of the first serum chemistry samples of 131 admitted neonates (58.8% male); median (IQR) age 10 (7, 14) days were analyzed. Electrolyte abnormalities, most commonly sodium and chloride, were present in 74.8% of the samples. Fifty-six neonates (42.7%) had AKI, 5 of them (8.9%) being in the severe category. More male neonates had AKI than females (62.5% vs 37.5%). There was a positive correlation between the degree of AKI and the numbers of deranged electrolytes (ᵨ = 0.200, p = 0.022).

Conclusion: The burden of AKI is high in this cohort.