Abstract: SA-PO072
Worldwide Incidence and Associated Mortality of AKI in Neonates: A Systematic Review and Meta-Analysis
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - II
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Kocharlakota, Jahnavi Phanidhar, All India Institute of Medical Sciences, New Delhi, Delhi, India
- Meena, Jitendra, All India Institute of Medical Sciences, New Delhi, Delhi, India
- Yadav, Joginder Kumar, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Kumar, Amit, All India Institute of Medical Sciences, New Delhi, Delhi, India
- Sinha, Aditi, All India Institute of Medical Sciences, New Delhi, Delhi, India
- Hari, Pankaj, All India Institute of Medical Sciences, New Delhi, Delhi, India
- Bagga, Arvind, All India Institute of Medical Sciences, New Delhi, Delhi, India
Background
There is limited literature on the global incidence of acute kidney injury (AKI) and associated mortality in neonates. We aim to systematically assess the worldwide incidence of AKI in neonates to increase awareness and inform policymakers.
Methods
We searched three databases (PubMed, Embase, Web of Sciences) from 2004 to December 2022 without language or geographical restrictions. Cohort and Cross-sectional studies reporting the incidence of AKI in neonates were included in this systematic review. Eligible studies had at least 10 participants and used AKIN, RIFLE, and KDIGO or their equivalent criteria to define AKI. Two authors independently extracted data about the study and patients’ characteristics and outcomes (incidence and AKI-associated mortality) and assessed the risk of bias. We used a random-effects meta-analysis to generate pooled estimates.
Results
From the initial 6990 records, we included 201 studies (98470 neonates) from 51 countries. The pooled incidence of any stage AKI was 34% (95% confidence interval: 31-37), and that of severe AKI was 15% (14-17). The incidence of AKI was lower in high-income 31% (27-35), low-middle-income 40% (32-48), and low-income 47% (6-97) countries. Pooled mortality was higher (OR 3.2; 95% CI 2.9-3.5) in neonates with AKI (29%; 95% CI 25-34) compared to those without AKI (8%; 95% CI 8-10). Mortality was lower in high-income 25% (20-30), low-middle-income 30% (20-42), and low-income 37% (20-56) countries.
Conclusion
AKI was observed in almost one-third of hospitalized neonates and is associated with increased mortality risk. Incidence and mortality associated with AKI were higher in low-middle-income countries than in high-income countries.
PRISMA 2020 flow diagram for new systematic reviews which included searches of databases, registers and other sources.
Funding
- Government Support – Non-U.S.