Acute kidney injury in neonates admitted to a tertiary institution in North Central Nigeria

Abstract

Background:Acute kidney injury (AKI) may be defined as a sudden decline in kidney function or an inability of the kidney to maintain fluid and electrolyte homeostasis.AKI impacts significantly neonatal outcomes due to the functional immaturity of the kidneys. Both creatinine and cystatin C are endogenous markers used to determine estimated glomerular filtration rate, which is a measure of renal function

Aims: This study was carried out to determine the incidence of AKI(Acute kidney injury) in neonates admitted and the ability of creatinine and cystatin C to predict AKI.

Methodology: A prospective study was conducted involving one hundred and seventy-three neonates admitted at the (Special care baby unit) SCBU of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria over a period of five months between July and November 2020. The renal function of the babies was evaluated. The blood samples were taken on admission for serum cystatin C and  serum creatinine and at 48 hours for serum creatinine. Cystatin C was analyzed by Goldsite protein analyzer which uses the nephelometry principle. Creatinine was analyzed by the Jaffe method.

Results: Fourteen (8.6%) of the neonates had AKI according to the neonatal KDIGO (kidney disease improving global outcomes) criteria.  Using the Receiver operative curve, the cystatin C level at admission had a higher predictive ability to diagnose AKI, the AUC for cystatin C was 0.682 compared to 0.281 for creatinine. 

Conclusion: Cystatin C is moderately predictive of AKI in neonates and is a better predictor of AKI, than creatinine among neonates.