Acute Renal Failure in Neonates, Single Center Experience: Child's Central Teaching Hospital


ABSTRACT:BACKGROUND:Acute renal failure is an acute deterioration in the ability of the kidneys to maintain homeostasis of body fluids, electrolytes and is associated with acute decrease in the glomerular filtration rate that leads to retention of toxic metabolic end products. It’s incidence in hospitalized neonates is 8-24%. The main causes of acute renal failure in neonates are pre-renal in nature, intrinsic and post-renal mechanisms of failure are much rarer conditions.OBJECTIVE: To evaluate; types, associated predisposing factors, and short term outcomes of renal failure in neonates of neonatal unit in Child’s Central Teaching Hospital, and to compare the results with those reported in the literature.PATIENTS AND METHODS: A cross sectional study was carried out on 30 neonates with acute renal failure admitted to neonatal unit in Child’s Central Teaching Hospital during the period from 1st of June 2012 to 30th of November 2012.RESULTS: There were 43 cases diagnosed as renal failure out of 927 hospitalized neonates (4.63%).Thirteen cases were excluded according to the inclusion criteria, so only 30 cases were enrolled in this study. Male to female ratio was 1.7:1. Most of patients were term (86.7%). The prevalence of pre-renal, renal and post renal causes of acute renal failure were 76.6%, 16.7% and 6.7% respectively. The most common predisposing factors for acute renal failure in this study were sepsis (80%), perinatal asphyxia (10%), heart failure (3, 4%). Most patients had more than one predisposing factor. Among admitted neonates with renal failure, mortality rate was 16.7% and it was significantly higher in patients with sepsis (P<0.05).CONCLUSION: Early recognition of risk factors such as sepsis, perinatal asphyxia or, heart failure, and rapid effective treatment of contributing conditions will decrease acute renal failure in the neonatal period.