International Journal of Research in Medical Sciences | July 2020 | Vol 8 | Issue 7 Page 2477
International Journal of Research in Medical Sciences
Ikpeme EE et al. Int J Res Med Sci. 2020 Jul;8(7):2477-2481
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Incidence of acute kidney injury in asphyxiated babies in university of
Uyo teaching hospital, Uyo, Nigeria
Ikpeme Enobong Emmanuel
1
*, Dixonumo Ofonime Tony
1
, Udoh Mary Paulinus
1
,
Udo Jacob J.
2
INTRODUCTION
Acute kidney injury (AKI), the term that has replaced the
term Acute Renal Failure (ARF) is defined as an abrupt
(within hours) decrease in kidney function, which
compasses both injury (structural damage) and
impairment (loss of function).¹ It is characterized by a
reversible increase in blood concentration of creatinine
and nitrogenous waste products and inability of the
kidneys to regulate fluid and electrolyte homeostasis
appropriately.
1
The Acute Dialysis Quality Initiative
(ADQI) group standardized the definition of AKI using
the RIFLE criteria, a mnemonic for three levels of
severity; Risk, Injury and Failure and two outcomes; Loss
of kidney function and End-stage kidney disease.
1,2
The Acute Kidney Injury Network (AKIN) devised strata
that defined AKI based on time in relation to absolute
creatinine increase, percentage increase, or documented
oliguria.
3
A new consensus definition merging the RIFLE
1
Department of Pediatrics, University of Uyo Teaching Hospital, PMB 1136, Uyo, Akwa Ibom State, Nigeria
2
Department of Pediatrics, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
Received: 13 May 2020
Accepted: 06 June 2020
*Correspondence:
Dr. Ikpeme Enobong Emmanuel,
E-mail: enobong.ikpeme@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Acute Kidney Injury (AKI) is a consequence of birth asphyxia. In resource poor countries like ours,
birth asphyxia still contributes to the high rates of neonatal morbidity and mortality. A few studies have reported the
incidence of AKI in birth asphyxia in Nigeria but none from Uyo, south-south region of Nigeria.
Methods: A descriptive cross sectional study carried out in the Newborn Unit of the University of Uyo Teaching
hospital, Uyo, Nigeria over a period of eight months. One hundred and four term neonates with provisional diagnosis
of birth asphyxia using Apgar scoring were recruited. Blood sample was collected within six hours of life from each
subject for serum creatinine estimation using modified Jaffe method. Urine output was assessed by application of
plastic collection bag to the skin by adhesive patch. AKI was diagnosed when sCr >1.5mg/dl while oliguria was
defined as urinary output <1.5ml/kg/hour.
Results: Of the total of 104 asphyxiated neonates enrolled into the study, 56 (53.8%) were males while 48 (46.2%)
were females giving a male/female ratio of 1.2:1. Twenty-eight (26.9%) of the subjects had severe birth asphyxia; 52
(50%) had moderate birth asphyxia while 24 (23.1%) were mildly asphyxiated. Incidence of AKI was 48 (46.1%),
twelve (11.5%) had AKI based on serum creatinine criteria while 36 (34.6%) had AKI based on urinary output
criteria. The mean urinary output (ml/kg/hr) for the subjects was 1.65±0.68 while the mean serum creatinine (mg/dl)
was 0.88±0.46.
Conclusions: The incidence of AKI among asphyxiated neonates in our locale is high at 46.1%.
Keywords: Acute kidney injury, Birth asphyxia, Incidence, Neonates
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20202882