Abstract

Critically ill newborns are at greater risk of developing ARF. Non-oliguric renal failure is becoming increasingly recognized in newborns. Acute renal failure is best prevented; hitherto, early recognition and appropriate treatment could be life saving in some instances. The present study was carried out to determine the incidence, clinical features, etiology and outcome of oliguric and non-oliguric renal failure in sick newborns admitted in neonatal unit, pediatric hospital, Bikaner. Consecutive 100 hospital born & 100 out born sick newborns admitted in pediatric neonatal unit, S. P. Medical College, Bikaner were studied. Incidence of ARF was 17.5% in hospitalized sick newborns. Incidence of functional Renal Failure was 37.14%, while 62.86% cases were of Intrinsic Renal Failure. Incidence of non-oliguric renal failure (54.55%) was more than oliguric renal failure (45.45%). Mean urine output in oliguric newborn was 0.60014 ml/kg/hr while in non oliguric was 1.920.63 ml/kg/hr (p<0.01). Non oliguric ARF cases had lower mean serum urea level (103.77 58.25) as compared to oliguric ARF (146.9583.23)(p<0.01). Other renal indices were comparable in both oliguric non oliguric groups. The case fatality ratio was similar in non oliguric ARF (25%) as compared to oliguric (50%). Mortality was higher in preterm, LBW babies, advanced age at the time of diagnosis, outborn and intrinsic renal failure cases. Neonatal septicemia was leading cause of mortality (47.62%) followed by NEC, shock, RDS/pneumonia and perinatal asphyxia. An obvious implication of our study is that the habit of monitoring only urine volume as an index of renal function may be seriously misleading.