title: Neonatal acute kidney injury in a tertiary center in a developing country.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common contributor to morbidity and mortality in newborns, with prevalences varying by population and hospital. A study of AKI in newborns in tertiary care centers in Thailand, a developing country with limited resources, has not been conducted yet.
  
  
  METHODS
  The aim of this study was to determine the prevalence of AKI in newborns in a tertiary care hospital in southern Thailand and to investigate the etiology, mortality and risk factors of mortality. The records of patients aged <30 days with high serum creatinine, admitted from 1984 to 2007, were retrospectively reviewed.
  
  
  RESULTS
  Eighty-eight boys and 51 girls were enrolled; 61.4% were premature and 56.5% had a birth weight <2500 g. The prevalence of newborn AKI increased from 0.9 to 6.3% during the 24-year study period. Thirty-nine and 65% had renal failure within 2 and 7 days post-birth, respectively. Sepsis was the most common cause of AKI (30.9%) followed by hypovolemia (18.7%), kidney, ureter and bladder (KUB) anomalies (12.2%), congestive heart failure (12.2%) and birth asphyxia (11.5%). Indomethacin caused AKI in 24.4% with gestational age <32 weeks. Sepsis-induced AKI had the highest mortality rate (65.1%) with an overall mortality rate of 38.8% and nearly 14 times the risk of death compared to hypovolemia-induced AKI.
  
  
  CONCLUSIONS
  The prevalence of newborn AKI in our Thai tertiary center over 24 years was 6.3% of admitted newborns. Sepsis was the most common cause of AKI and sepsis-induced AKI is the most common cause of death. Disease etiology was the only risk factor for mortality.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. vprayong@gmail.com
authors.forename: Prayong
authors.initials: P
authors.lastname: Vachvanichsanong
authors.forename: Edward
authors.initials: E
authors.lastname: McNeil
authors.forename: Supaporn
authors.initials: S
authors.lastname: Dissaneevate
authors.forename: Pornsak
authors.initials: P
authors.lastname: Dissaneewate
authors.forename: Prasin
authors.initials: P
authors.lastname: Chanvitan
authors.forename: Waricha
authors.initials: W
authors.lastname: Janjindamai
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D003906:Developing Countries; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D015996:Survival Rate; D013785:Thailand / Q000453:epidemiology