Assessment of acute kidney injury among asphyxiated neonates

Abstract EN

Background: Perinatal asphyxia is characterized by an impairment of respiratory gases exchange resulting in hypoxemia and hypercapnia, accompanied by metabolic acidosis.

Early recognition of acute kidney injury is important in asphyxiated neonates as the kidneys are extremely sensitive to hypoxia which if prolonged may lead to irreversible cortical necrosis.

Aim: This study aimed to assess renal functions in neonates with perinatal asphyxia.

Design& setting: The study is a case control study that was conducted in neonatal intensive care unit of Faculty of Medicine, Ain Shams University and Wadi El- Nil hospital in the period from June 2014 to June 2015.

Patients& Methods: The study included 60 neonates with perinatal asphyxia based on the criteria of American Academy of Pediatrics.

Thirty age/sex matched apparently healthy neonates as a control group.

Blood samples for serum creatinine, blood urea levels were assessed, estimation of GFR and urine output assessment were performed.

Results: There was an increase in creatinine level at 24 hours and at 48 hours and a reduction of GFR at 48 hours in patients group than control group with highly significant p- values0.029, <0.001 and <0.001 respectively.

HIE severity correlated significantly with urine output at 24 and 48 hours.

HIE severity correlated significantly with and creatinine level at 24 and 48 hours, while no statistically significant relation was found between HIE severity and blood urea.

Conclusion: Serum creatinine and GFR are reliable markers for renal function assessment in neonates with perinatal asphyxia and have to be assessed to reduce morbidity and mortality.