Determinants of the Outcomes of Acute Kidney Injury in Neonates at Kenyatta National Hospital’s Paediatric Unit

Abstract

Background: Neonatal acute kidney injury [AKI] is a significant health concern across the globe due to its rising incidence and association with adverse outcomes. AKI in neonates is often multifactorial and may result from prenatal, perinatal or postnatal insults or any combination thereof. An understanding of the predictors of outcomes of AKI among neonates is therefore essential. Objective: To assess the determinants of the outcomes of acute kidney injury in neonates at the paediatric unit of Kenyatta National Hospital. Methods: We conducted a retrospective study involving a retrospective desk review of the medical records of neonates aged 1-28 days treated with AKI at Kenyatta National Hospital’s pediatric unit. Medical records of 141 neonates with AKI seen in the hospital between 1st January and 31st December, 2021 were examined with data retrieved using a Data Abstraction Form. Data were analyzed through descriptive statistics while logistic regression analysis was utilized to analyze the association between the study variables at 5% significance level. Results: From the results, 62.4% [n = 88] of the neonates lived following treatment while 37.6% [n = 53] died. The renal function related factors found to be significant predictors of outcomes of AKI in the neonates were serum creatinine [SCr] values [β = -1.792, p = .000] and urine output values [β = 1.720, p = .011]. The treatment related factors that were significant predictors of outcomes of AKI in the neonates were stage of the AKI [β = -1.014, p = .007]; onset of AKI [β = 1.101, p = .022] and being mechanically ventilated [β = -3.788, p =.003]. Neonate related variables were, however, found not to be significant predictors of outcomes of neonatal AKI. Conclusion: Outcomes of AKI in neonates were largely influenced by various renal function and treatment related factors. Recommendation: Focus is required on efforts needed to improve outcomes of AKI in this vulnerable patient population.