title: Acute renal failure in critically ill newborns increases the risk of death: a prospective observational study from India.
abstract: OBJECTIVE
  To determine the incidence and risk factors of acute renal failure (ARF) in hospitalized critically ill neonates and analyze outcome of all neonates with renal failure in relation to risk factors.
  
  
  METHODS
  In this prospective observational study 815 infants were enrolled. Renal profile (blood urea and serum creatinine) was done after 12 h of life (or at the time of admission for outborn babies) and then every 12 hourly. Daily 24 h urine output was evaluated.
  
  
  RESULTS
  Incidence of renal failure in critically ill neonates was 10.67%. Out of 87 ARF neonates 52 (60%) expired. Mortality in the renal failure group was significantly higher in comparison to control group (p < 0.01). Non-oliguric renal failure was more common than oliguric renal failure, but mortality in the oliguric renal failure group was more. Neonatal sepsis was the most common cause of ARF. Eight neonates underwent peritoneal dialysis (PD) out of which there were seven neonatal deaths.
  
  
  CONCLUSIONS
  Prognosis of neonates with ARF requiring PD was very poor. It can thus be concluded that the health care personal should do rapid diagnosis of ARF in neonates with potential risk factors and also goal at an early and effective treatment of these risk factors in neonates with ARF.
authors.affiliation: a Department of Neonatology , King Edward Memorial Hospital and Seth G.S. Medical College , Mumbai , India .
authors.forename: Ankur
authors.initials: A
authors.lastname: Patel
authors.affiliation: b Department of Neonatology , Fernandez Hospital , Hyderabad, Andhra Pradesh , India .
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
authors.affiliation: c Department of Pathology , N.K.P. Salve Medical College , Nagpur , Maharashtra , India , and.
authors.forename: Sweta
authors.initials: S
authors.lastname: Shastri
authors.affiliation: d R.N.T. Medical College , Udaipur , Rajasthan , India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Sharma
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality*; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D054238:Perinatal Mortality; D011446:Prospective Studies
keywords: Acute renal failure; birth asphyxia; mortality; neonates; risk factors; sepsis