Risk factors and kidney outcomes of neonatal acute kidney injury at Samut Sakhon Hospital

Abstract

Background: Acute kidney injury (AKI) in neonates is often underdiagnosed due to the unique renal physiology in this age group, which differs from that of older children. This leads to delayed diagnosis, increased complications, and higher mortality rates.

Objective: To identify risk factors associated with the development of AKI in neonates and evaluate the outcomes of treatment.

Methods: This cross-sectional descriptive study was conducted in neonates with and without AKI who were admitted between July 1, 2024, and May 31, 2025. Risk factors were analyzed using univariable and multivariable regression analysis.

Results: There were 86 neonates and 43 of them were diagnosed with AKI. Among these patients, 22 (51.2%) had stage 1, 14 (32.6%) had stage 2, and 7 (16.3%) had stage 3. Factors significantly associated with the development of AKI were a diagnosis of patent ductus arteriosus (OR 4.9; 95% CI 1.2–20.4), shock (OR 15.1; 95% CI 1.6–139.7), and exposure to aminoglycosides (OR 4.5; 95% CI 1.5–13.4). The mortality rate among neonates with AKI was 25.6%.

Conclusion: Neonates diagnosed with PDA or shock, or treated with aminoglycosides, were at increased risk of AKI. These patients should be closely monitored for renal function to enable early diagnosis and prompt management, aiming to reduce complications and improve survival outcomes.