INCIDENCE, RISK FACTORS AND PROGNOSIS OF ACUTE KIDNEY INJURY IN PREMATURE NEWBORNS HOSPITALIZED IN TWO HOSPITALS IN YAOUNDE CAMEROON

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INCIDENCE, RISK FACTORS AND PROGNOSIS OF ACUTE KIDNEY INJURY IN PREMATURE NEWBORNS HOSPITALIZED IN TWO HOSPITALS IN YAOUNDE CAMEROON

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Co-author 1

NZANA Victorine Bandolo vickybandolo@yahoo.fr Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Department of Internal Medicine and Specialty Yaounde Cameroon * Yaounde University Teaching hospital Internal Medicine Yaounde Cameroon

Co-author 2

NYEUMENOU Josiane josianenyeumenoutcheumbe@gmail.com Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Department of Pediatrics Yaounde Cameroon -

Co-author 3

MAIMOUNA Mahamat m_mahamat@yahoo.fr Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Department of Internal Medicine and Specialty Yaounde Cameroon - Yaounde General Hospital Internal Medicine Yaounde Cameroon

Co-author 4

NANSEU Richie nanseu@yahoo.fr Post Graduate School for live Sciences, Health and Environment, Unversity of Yaounde I Doctoral Research Unit for Health and Environment Yaounde Cameroon -

Co-author 5

KAZE Francois f_kaze@yahoo.fr Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Department of Internal Medicine and Specialty Yaounde Cameroon -

Co-author 6

MAH Evelyn mahevelyn@gmail.com Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Department of Pediatrics Yaounde Cameroon -

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

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Co-author 15

Introduction

Acute kidney injury (AKI) is a common complication among hospitalized premature newborns in developed countries. Though it is a significant cause of morbidity and mortality in these countries, little is known with regards to its impact in resource limited countries.

Methods

We conducted a prospective cohort study over a period of five months in the neonatal units of 2 hospitals in Yaounde. We included admitted, premature newborns aged 3 days, whose guardians had agreed to participate in the study. The selected newborns were monitored from day 3 to day 14. AKI was defined according to the neonatal KDIGO criteria as an increase in serum creatinine ≥ 0.3 mg/ dl within 48 hours or elevation of serum creatinine ≥ 1.5 to 1.9 × baseline serum creatinine within 7 days and/or urine output ˃ 0.5 and ≤1 ml/kg/h in 24 hours). The diagnosis was made on day 3 based on urine output and/or on day 5 or day 10 based on creatinine levels. Baseline creatinine levels were measured on the third day of life and urine output was assessed by weighing diapers daily.

Results

Table I :Independent risk factors for acute kidney injury Table II : Comparing outcomes in the AKI and non AKI groups

Of the 80 (51,3% males) newborns included, 21 had developed AKI, accounting for an incidence of 26.3%. All neonates had stage 1 AKI . Dehydration was an independent risk factor for AKI (aOR: 5.33; 95% CI: 1.43-19.83; ap = 0.013). Mortality rate was 42.9% in neonates with AKI, compared with 16.9% in those without AKI, giving a 2.4-fold increase in the risk of death for neonates with AKI (RR: 2.40 (1.20-4.82) p = 0.017). All survivors had complete recovery of kidney function at day 14.

Conclusion

The incidence of AKI is very high among admitted preterm neonates and is associated with high mortality. Dehydration is the main risk factor, underlining the importance of early detection and prompt correction to improve outcome.

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