Research Article

Incidence, risk factors, and outcome of AKI in preterm neonates admitted to the NICU

Rafia Gul, Lubna Asghar, Samer Fatima, Muhammad Usman, Furqan Saleem, Irshad Hussain, Sidra Hamayoon

Annals of Pakistan Institute of Medical Sciences · Vol. 21, No. 4 · Pages 665–672 · Published December 21, 2025
DOI: 10.48036/apims.v21i4.1557

AKI in Preterm Babies: In Brief

AKI in preterm babies (acute kidney injury) is a sudden drop in kidney function. It is common in premature babies in intensive care, but its causes and effects are still being studied. This study followed 432 preterm babies to see how often AKI happened, what raised the risk, and how the babies did.

Key Points

• A prospective cohort study of 432 preterm neonates born at 28 to 36 weeks, in the newborn intensive care units of Fatima Memorial Hospital, Lahore, from April to October 2024.
• About 41% of the babies (178 of 432) developed acute kidney injury, graded with modified KDIGO criteria. Most cases were stage 1 or stage 2.
• Maternal anemia, hemodynamically significant patent ductus arteriosus (hsPDA) and mechanical ventilation were independent risk factors, while antenatal steroid exposure appeared protective.
• Mortality was 16.3% in babies with acute kidney injury and rose to 30% in those with stage 3 injury.

What This Means for Parents

AKI in preterm babies is common, and in this study most cases were mild, but severe kidney injury carried a much higher risk. Some of the risk can be lowered before birth: treating anemia during pregnancy and, when early delivery is expected, giving the mother steroid injections, which appeared to protect babies’ kidneys. An Antenatal Consult helps plan this. After birth, the NICU team watches urine output, blood tests and medicines closely, especially in babies on a breathing machine or with a heart duct problem (PDA). Kidney checks often continue during Preemie Care after discharge.

AKI in Preterm BabiesAcute Kidney InjuryPremature BabiesMaternal AnemiahsPDAMechanical VentilationKDIGO

Published in the Annals of Pakistan Institute of Medical Sciences, Vol. 21, No. 4 (October–December 2025), Original Articles. PDF shared by the authors.