University of Nairobi, Department of Paediatrics and Child Health.
Thika Level Five Hospital, Paediatrics Department.
Afr Health Sci. 2023 Mar;23(1):704-710. doi: 10.4314/ahs.v23i1.75.
Unique aspects of neonatal renal physiology enhance the occurrence of Acute Kidney Injury (AKI) as a complication of neonatal sepsis. The study sought to determine prevalence of AKI and its characteristics in neonates with suspected sepsis.
A cross-sectional study was conducted at Kenyatta National Hospital among neonates aged 0-28 days. AKI was defined as serum creatinine of more than 100µmmol/l.
Among 332 neonates included 120 had AKI giving a prevalence of 36.1% (95% CI 31 to 41.6). Based on RIFLE criteria the commonest AKI presentation was Failure 72 (62.6%, 95% CI 53.6 to 71.6), followed by Injury 26 (22.6%, 95% CI 14.8 to 30.4) and then Risk 17 (14.8%, 95% CI 8.2 to 21.3). AKI was more common in neonates with suspected late onset sepsis (p=0.004). Maternal fever in the preceding week to delivery and presence of either puerperal sepsis or post-partum hemorrhage were significantly associated with severe AKI (p=0.004 and p=0.038).
Prevalence of AKI was high; those with suspected late onset sepsis were more likely to develop AKI compared to early onset sepsis. Presence of maternal fever preceding delivery and presence of either puerperal sepsis or postpartum hemorrhage were associated with severe forms of AKI.
新生儿肾脏生理学的独特方面增加了急性肾损伤（AKI）作为新生儿败血症并发症的发生。本研究旨在确定疑似败血症新生儿中 AKI 的患病率及其特征。
在肯雅塔国家医院对 0-28 天龄的新生儿进行了横断面研究。AKI 的定义为血清肌酐超过 100µmmol/l。
在 332 名新生儿中，120 名患有 AKI，患病率为 36.1%（95%CI 31-41.6）。根据 RIFLE 标准，最常见的 AKI 表现为衰竭 72 例（62.6%，95%CI 53.6-71.6），其次是损伤 26 例（22.6%，95%CI 14.8-30.4），然后是风险 17 例（14.8%，95%CI 8.2-21.3）。疑似晚发性败血症的新生儿 AKI 更常见（p=0.004）。分娩前一周的母体发热以及产褥期败血症或产后出血的存在与严重 AKI 显著相关（p=0.004 和 p=0.038）。
AKI 的患病率很高；与早发性败血症相比，疑似晚发性败血症的新生儿更有可能发生 AKI。分娩前母体发热的存在以及产褥期败血症或产后出血的存在与严重形式的 AKI 相关。
