Assessment of renal insufficiency in critically ill neonates by measuring the urinary alpha one micro globulin

الملخص EN

Background : perinatal asphyxia is an important cause of renal tubular damage or acute renal failure in neonates.

Also neonatal sepsis may lead to both tubular injury and acute renal failure.

Perinatal asphyxia together with sepsis and nephrotoxic drugs constitutes the major causes of renal failure in neonates.

Accordingly, measuring alpha one macroglobulin to study renal tubular damage, as well as assessing other renal function parameters is useful (1) Aims : our aim is to assess the effect of perinatal asphyxia and sepsis on the proximal tubular function by estimating urinary alpha one micro globin (a i-M.).

Methods: Our study included (96) term neonates (38-42weeks) delivered at AL Sabah Maternity Hospital in Kuwait .Our cases were divided into (3) groups , group (l),sixteen healthy term neonates (control group), group(2) 50 asphyxiated neonates and group(3) 30 septic neonates.

All cases were subjected to complete history, clinical examination and laboratory investigations (complete blood picture, C reactive protein, blood urea nitrogen, serum keratinize, serum sodium, potassium and complete urine analysis, urinary a j-macroglobulin. Results : comparing our cases control, asphyxiated and septic neonates groups as regards sex, gestational age and mode of delivery we found no statistical significant difference among all studied groups.

Normal term neonates have urinary alpha one micro globulin during the first day of life 93 ± 60.3ug / mg Cr and 63.6 ± 32.2u g / mg Cr on the third day.

Comparing urinary alpha one microglobun results of both groups 2 and 3 with those of group J.

we found statistically significant higher loss of (a rM.) among asphyxiated group (2) while there was not among the septic group .Both group 2, 3 we reported higher loss of a rM.

During third day of life, indicating definite proximal renal tubular insults.

Conclusion: assessment of renal tubular injury by a rM.

And other renal functions including serum keratinize and urea nitrogen is essential among asphyxiated and septic neonates.

Alpha one micro globulin can contribute in the noninvasive early detection of renal pathologies this gives early diagnosis with concomitant interference by adequate treatment to minimize the progression and or persistence of renal damage.