Prevalence and associated factors of acute kidney injury among preterm neonates admitted at the special care unit of Kawempe National Referral Hospital

Abstract

Background: Acute kidney injury (AKI) is one of the most common conditions among neonates hospitalized in neonatal intensive care units (NICUs) and is known to be associated with short- and long-term complications. Preterm neonates are at greatest risk, however there is paucity of data as regards Acute Kidney Injury occurrence among this population in this study area. This study aimed to investigate the prevalence and associated factors of acute kidney injury among preterm neonates admitted at the special care unit of Kawempe National Referral Hospital, Kampala, Uganda. Methods: This study was a prospective cohort study conducted at the Special Care Unit of Kawempe National Referral Hospital. Data was collected from preterm neonates who met the eligibility criteria. A binary logistic regression analysis was done to identify factors associated with AKI. Variables with a P-value <0.05 were considered as statistically significant in multiple logistic regression analysis. Data analysis was done using STATA 17. Results: A total of 288 participants were enrolled in the study and analysed data of 285. Of these, 23(8.1%), (95%CI=5.4-11.8%) had AKI. Of the 23 that had AKI, 20(87%) neonates had stage 1, 1(4.3%) had stage 2 and 2(8.7%) with stage 3 AKI. Maternal illness (AOR=33.8; 95%CI= (8.89-128.4) and sepsis (AOR=4.3; 95%CI= (1.12-16.49)) were factors significantly associated with AKI among the preterm neonates. Conclusion: This study revealed that 8% of preterm neonates had AKI, hence a common occurrence. Preterm neonates especially those with identified associated factors like sepsis should have their serum creatinine serially checked to aid early recognition of AKI, prompt treatment, monitoring and follow up to avert the known short- and long-term complications. Key words: Acute kidney injury, preterm, neonate, prevalence and associated factors.