Prevalence of acute renal failure in neonates admitted to Kermanshah Razi Hospital (2003-2004)

Introduction: Acute renal failure (ARF) is a common problem in the neonatal intensive care unit (NICU). In most cases, ARF is associated with other conditions such as sepsis, perinatal asphexia and prematurity that could result in mortality and morbidity. This study examines the prevalence, the course of illness, early prognosis and risk factors associated with development of ARF in the neonatal period.

Materials and Methods: This descriptive study included 938 neonates admitted to Kermanshah Razi Hospital. ARF was defined when serum creatinine level ≥1.5mg/dl with the serum urea ≥50mg/dl and course of illness was compatible with ARF. Convenient sampling was carried out, selecting the patients based on the above mentioned criteria. Medical records of these patients were reviewed and the data were then analyzed using SSPSS software, chi- square t test.

Results: 32 out of 938 patients (3.41%) had ARF, of whom 62.5% were males and 37.5% females. The figure for term, preterm, and post term neonates was 75%, 15.63% and 9.37% respectively. 68.75% were aged 1-5 with 31.25% between 6-28 days. While a normal birth weight was observed in 50% of the cases, 43.75% of the patients had a low birth weight, with 6.25% belonging to the very low birth weight group. Sepsis was the most common condition at 38.88%, followed by pneumonia and dehydration at 8.34% each. Associate congenital anomalies were present in 37.45% of the cases. Frequency of oliguric renal failure was 18.75% and mortality of neonates with ARF was 62.5%.  Therapeutic interventions were supportive in 92.75% of the cases, and peritoneal dialysis was required for the other 6.25%.

Conclusion: The study showed that at Razi hospital, ARF was commonly associated with preventable conditions such as sepsis. In most cases, patients can be managed using conservative therapy with no need for dialysis.