title: The main etiologies of acute kidney injury in the newborns hospitalized in the neonatal intensive care unit.
abstract: BACKGROUND
  Acute kidney injury (AKI) is one of the most common diseases among the newborns hospitalized in the neonatal intensive care units (NICUs), which is usually resulted from predisposing factors including sepsis, hypovolemia, asphyxia, respiratory distress syndrome (RDS), and heart failure. The goal of this study was to assess main etiologies, relevant risk factors, and early outcome of neonatal AKI.
  
  
  METHODS
  In a cross- sectional study, 49 consecutive neonates hospitalized in NICU of Besat hospital with diagnosis of AKI from October 2009 to October 2011 were investigated through census sampling method. AKI was diagnosed based on urine output and serum creatinine levels.
  
  
  RESULTS
  The prevalence of AKI was 1.54% (49 out of 3166 newborns hospitalized in NICU) with the female: male was 7:1. Thirty-nine patients (79.5%) were full-term neonates. Oliguria was observed in 38 (77.5%) patients. Sepsis was the most common predisposing factor for AKI in 77.5% of patients (n = 38) accompanied with the highest mortality rate among other factors (30.5%). Other leading causes of AKI included hypovolemia secondary to dehydration, followed by hypoxia secondary to RDS, patent ductus arteriosus, posterior urethral valve, asphyxia, and renal venous thrombosis. A positive relationship was observed between neonates' age, sex, urine output, and also between serum creatinine levels with initiation of dialysis. The mortality rate among the newborns hospitalized with AKI was 36.7%. Eighteen (36.7%) newborns were treated with peritoneal dialysis (PD) of whom 10 patients (55.6%) died, 31 patients were managed conservatively of whom five neonate died (25.9%).
  
  
  CONCLUSIONS
  Prognosis of AKI in the oliguric neonates requiring PD is very poor. It is thus recommended to prevent AKI by predicting and rapid diagnosis of AKI in patients with potential risk factors and also by early and effective treatment of such factors in individuals with AKI.
authors.affiliation: Department of Pediatrics, Hamadan University of Medical Sciences, Hamedan, IR Iran.
authors.forename: Hossein Emad
authors.initials: HE
authors.lastname: Momtaz
authors.affiliation: Department of Pediatrics, Hamadan University of Medical Sciences, Hamedan, IR Iran.
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Sabzehei
authors.affiliation: Department of Pediatrics, Hamadan University of Medical Sciences, Hamedan, IR Iran.
authors.forename: Bahman
authors.initials: B
authors.lastname: Rasuli
authors.affiliation: Department of Pediatrics, Hamadan University of Medical Sciences, Hamedan, IR Iran.
authors.forename: Saadat
authors.initials: S
authors.lastname: Torabian
keywords: Acute kidney injury; newborns; outcomes