Aim: Acute renal failure (ARF) is characterized by a sudden impairment in renal function, leading to inability of the kidneys to excrete nitrogenous waste. Acute renal failure is a frequent clinical condition in neonatal intensive care units (NICU), with a reported prevalence of 6-11%. In this study we aimed to define incidence of ARF among hospitalised neonates in our NICU, the risk factors related to ARF, and the outcome of the neonates with ARF treated in the NICU of our hospital.

Method: A retrospective study was designed during 2005, to identify the neonates with ARF (serum creatinine level over 1.5 mg/dL, or urea over 55 mg/dL plus creatinine level increased over 0.2 mg/dL daily) in the NICU of our hospital.

Results: There were 84 neonates (7.98%) with ARF among 1053 neonates hospitalized in our hospital neonatal intensive care unit with following characteristics: mean weight of 2896,1±100,2 gr (650-4820 g), postnatal ages of 5.1±5 days, female/male ratio of 30/54=0.56, prematurity ratio of 35,7% (n=30). The mean blood urea, creatinine, sodium, potasium and uric asit levels on admission were 99.2±60.3 mg/dL, 1.24±1.02 (0.1-6.5) mg/dL, 144.5±13.1 mEq/L, 5.2±1 (2.6- 8.2) mEq/L, and 7.1±4.6 (0.4-22.5) md/dL, respectively. Risk factors were as follows: dehydration over 10% (61,9%), aminoglycoside therapy (51,2%), other drugs (2,4%), sepsis (26,2%), mechanical ventilation (26,2%), parenteral nutrition (15,5%), asphyxia (9,5%), necrotising enterocolitis (9,5%), and congenital heart disease (8,3%). The ratios of prerenal azotemia and intrinsec ARF were 77,4%, and 22,6% respectively. Mortality ratio was 22,6% (n=19). Prematurity related disorders (n=12) and sepsis (n=3) were the most common reasons for exitus. We found significant relation between prematurity, intrensec ARF, mechanical ventilation and mortality.

Conclusion: Acute renal failure is a frequent clinical condition in NICU’s characterized by significant morbidity and mortality. The suspected neonates should be evaluated as soon as possible, and differentiation of prerenal, renal, and postrenal ARF should be decided. Besides supportive initial treatment, physician should identify the underlying risk factors, which could be corrected

Keywords: Newborn, renal failure, risk factors