Effects of Neonatal Septicemia on Renal Function
Authors/Creators
- 1. Department of Pediatrics, MLB Medical College, Jhansi
Description
An observational hospital based prospective study was conducted on 70 neonates with sepsis admitted in the Neonatology unit, Department of Paediatrics, MLB Medical College, Jhansi from Aug. 2016 to Sep. 2017 to evaluate the incidence of renal involvement in cases of neonates with septicemia and other contributing factors complicating acute kidney injury in them Sepsis was diagnosed on the basis of either a positive sepsis screen [Immature: Total neutrophil . ratio(I:T) > 0.2, micro –Erythrocyte Sedimentation Rate (ESR) > age in days +2 mm or >15 mm, C-Reactive Protein(CRP)> 1mg/dl, Total Leukocyte Count(TLC)1.5mg/dL with or without oliguria and with or without blood urea nitrogen (BUN) >20mg/dl on two separate occasions at least 24 hours apart. Oliguria was diagnosed when urine output was less than 1ml/Kg/hr. Out of the 70 neonates with sepsis,AKI was found in 23% (n=16) cases and majority of cases i.e. 75% (n=12) were nonoliguric, only 25% (n=4) were oliguric The association of Shock,Prolonged Rupture of Membranes(PROM) and Foul . Smelling Liquor (FSL) was also significant in neonates with AKI(68.75%vs 29.63%,p<0.05,60%vs 40%, p<0.05, 100%, p<0.05 respectively). Perinatal asphyxia did not significantly increase the occurrence of AKI in septic neonates The . mortality was higher in neonates with oliguricAKI (75%) as compared to non oliguricAKI (41.66%).AKI occurred in 23% neonates with sepsis. It was observed that AKI secondary to neonatal sepsis was predominantly nonoliguric. Factors like shock, prolonged rupture of Membranes (PROM), foul smelling liquor (FSL) and culture positivity were significant risk factors for development ofAKI in sepsis.
Files
5.pdf
Files
(70.0 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:d659bc9fb66e902b4e2d836286dde060
|
70.0 kB | Preview Download |
Additional details
References
- 1. Neveu H, kleinknecht D, Brivet F, Loirat P. Landais P. Prognostic factors in acute renal failure due to sepsis. Results of a prospective multicentre study. The French Study Group on Acute Renal Failure. Nephrol. Dial. Transplant, 1996;11:293-299
- 2. Bang AT, Bang RA, Bactule SB, Reddy HM, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999;354:1955-61.
- 3. Shankar MJ, Agarwal R, Deorari AK, Paul VK. Symposium on AIIMS protocols in neonatalogy IIISepsis in newborn. Indian J Pediatr. 2008;75:261-
- 4. Mortazavi F, Sakha HS, Nejati N.Acute Kidney Failure in Neonatal Period. Iran J Kidney Dis. 2009;3:136-140
- 5. Spitzer A. Renal physiology and functional development. In Pediatric Kidney Disease, Edelmann CM (ed).; Boston, Little Brown,1978;pp25.
- 6. Pradhan SK, Pradeep S, Swain A, Satpathy SK, Behera JN. A study on acute kidney injury (AKI) in neonatal sepsis: IOSR-JMDS.2014;13:01-4.
- 7. Pereira S, Pereira BJG, Bhakoo ON, NarangA, Sakhuja VS, Chugh KS. Peritoneal dialysis in neonates with acute renal failure. Ind J Pediatr. 1988;58:973-978.
- 8. Norman Jones AS, James E, Bland H, Groshong T. Renal failure in the newborn. Clin Ped. 1979;18:286- 290.
- 9. Jayshree G, Saila A, Sarana M S, Dutta A K. Renal d y s f u n c t i o n i n s e p t m i c n e w b o r n . I n d i a n Pediatrics.1991;28(1):25-29.
- 10. Ellis EN, Arnold WC. Use of urinary indices in renal failure in the newborn. Am J Dis Child.1982;136:615- 617.
- 11. Ballard JL, Khoury JC, Wedig K, Wang L, EilersWalsman BL, Lipp R. New Ballard score, expanded to include extremely premature infants. J Pediatr. 1991;119:417-423.
- 12. Mathur NB, Agarwal HS, Maria A. Acute renal failure in neonatal sepsis. Indian J Pediatr. 2006;73:499-502
- 13. Salah MH, Hamdi N, Algayar A, Khashab A. Effect of septicemia on renal performance in neonates. Med J Cario Univ. 2010;78:361-7.
- 14. Holda MAM, Purani C, Mehariya KM, Priyanshi P, Purvi P. Study of Effect of Neonatal Septicemia on Renal Function. Guj Medi J. 2015;70(1):83-87.
- 15. Jagrawal G,Arora V, Gunawat M, Malik P :Acute renal failure in neonatal septicemia. Int J Biomed Sci. 2455- 0566.
- 16. Durga D, Rudrappa S. Clinical profile and outcome of acute kidney injury in neonatal sepsis in a tertiary care centre. Int J Contem Pedia. 2017;4(2):635-644.
- 17. Brion L, Fleischman AR, McCarton C. A simple estimate of glomerular filtration rate in low birth weight infants during the first year of life: non invasive assessment of body composition and growth. J Pediatr. 1986;109:698- 707.
- 18. Chevalier RL, Campbell F, Brenbridge AG. Prognostic Factors in neonatal acute renal failure. Pediatr.1984;74 : 265-272.