Publication:

The incidence of acute kidney injury in newborns experiencing hypernatremic dehydration

Background Hypernatremic dehydration is a significant concern for neonates, particularly in hot climates where the risk factors for dehydration are heightened. It can lead to life-threatening complications such as acute renal failure. Determining the incidence of acute kidney injury (AKI) in newborns experiencing hypernatremic dehydration help to understand the relationship between hypernatremic dehydration and acute kidney injury in newborns, with the goal of enhancing patient care and outcomes.

Methods A hospital-based prospective study was conducted in the neonatal intensive care unit (NICU) at Navodaya Medical College, Raichur, over one year involving 50 neonates aged less than or equal to 28 days with hypernatremic dehydration. Neonates with congenital kidney anomalies, diagnosed with sepsis and who have experienced birth asphyxia were excluded. The diagnosis of AKI was based on the criteria outlined in the modified kidney disease: improving global outcomes (KDIGO).

Results Out of 50 neonates with hypernatremic dehydration 30 (66%) had AKI. Out of 33 neonates with AKI  3% had sodium levels between 146-149 mEq/l, 72.7% between 150-169 mEq/l and 24.2% between ≥170 mEq/l. p value is 0.003 (<0.05) and is statistically significant.

Conclusions Neonates who experience weight loss exceeding the normal physiological range and exhibit signs of dehydration should be assessed for hypernatremic dehydration. The incidence of AKI in newborns experiencing hypernatremic dehydration is a significant clinical concern that warrants attention. Early identification and management of hypernatremic dehydration are crucial to mitigate the risk of renal impairment.