Evaluating causes of acute renal failure in newborn infants

Abstract

Objective: Acute renal failure (ARF) is a common problem in admitted neonates in intensive care units. In most patients ARF accompanies with a predisposing factor such as sepsis, heart failure, perinatal asphyxia or prematurity. The objective of this study was to determine the causes and outcome of ARF in hospitalized newborn infants. Methodology: In a descriptive cross sectional study we evaluated neonates with ARF who had been hospitalized in Tabriz Children Hospital from March 2004 to September 2005. Results: There were 85 cases with diagnosed ARF in 3000 hospitalized neonates (2.83%). The mate to female ratio in patients with ARF was 2.03:1. Most of involved patients were term (70.6%). The prevalence of renal, pre renal and post renal causes of ARF was 49.4%, 43.5% and 7.1% respectively. The most common predisposing factors for ARF in our study were surgery (43.5%), perinatal asphyxia (36.5%), sepsis (32.9%), respiratory distress syndrome (25.9%), heart failure (20%) and feeding problems (20%). All patients had more than one predisposing factor. Among admitted neonates with ARF mortality rate was 20% and it was significantly higher in patients with assisted ventilation and sepsis (P<0.05). Conclusion: Early recognition of risk factors such as sepsis, perinatal asphyxia or, perioperative problems and rapid effective treatment of contributing conditions will reduce ARF in neonatal period.