Clinical Profile of Hypernatremic Dehydration in Neonates with Special Emphasis to Acute Kidney Injury
Journal Title: Journal Of Pediatric Critical Care - Year 2018, Vol 5, Issue 5
Abstract
Background : Hypernatremic dehydration is common among breast fed babies due to various reasons. Unless diagnosed early and treated properly, dehydration fever or hypernatremic dehydration is devastating condition. Hypernatremia itself or its improper treatment can cause neurological damage. Dehydration can lead to pre-renal injury which can further progress in to intrinsic renal failure, complicating the management. We present clinical profi le of hypernatremic dehydration with emphasis to kidney injury among neonates. Materials and Methods : It is prospective study conducted at tertiary care neonatal intensive care unit. Babies presenting with various symptoms were screened for hypernatremia, excluding other diseases. Kidney injury is assessed using fractional excretion of sodium. Results : out of 69 neonates 30 neonates with hypernatremia were selected with male: female ratio of 1:1.14. Majority of the babies 46.7% (n=14) presented within 1st week of life with fever being the most common symptom. Exclusively breastfed neonates (63.3%) were signifi cant in number compared to other forms of feeding like mixed feeding (23.3) or exclusively formula fed babies. Prerenal acute kidney injury (AKI) was seen in 11 babies (36.7%), whereas 7(23.3%) had intrinsic renal AKI, 12 (40%) babies had normal renal function. Pre-renal AKI was predominant renal injury among all the three grades of hypernatremia. Conclusions : Hypernatremic dehydration is important preventable, treatable dangerous condition in neonates. Central nervous system is most commonly affected, but acute renal failure is also an important complication. Early diagnosis and proper treatment gives good outcome, sometimes renal failure complicates the management.
Authors and Affiliations
Mahesh Maralihalli, Mahantesh Matti, Vijayasree Kathasagaram, Vijayi Kulkarni
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