Evaluation of Renal Function Test in Birth Asphyxia in Term Neonates
Journal Title: The Indian Journal of Maternal-Fetal and Neonatal Medicine - Year 2018, Vol 5, Issue 2
Abstract
Background: Acute renal failure is recognized complication of birth asphyxia. It carries a poor immediate prognosis and may result in permanent renal damage in upto 40% of survivors. Early recognition of acute renal failure is particularly important in asphyxiated neonates with HIE, in whom a stable biochemical milieu is vital, because it facilitates the administration of appropriate fluid and electrolyte replacement. Aim: To determine the incidence of renal failure in birth asphyxia and to correlate the severity of renal failure with HIE grading of asphyxiated neonates. Materials and Methods: 100 term (37-42 wks) neonates born with Apgar score of < 7 at 5 minutes after birth were selected as cases. All asphyxiated neonates (as per WHO definition) with clinical features of HIE are staged by Sarnat & Sarnat staging. Gestational age, birth weight relevant perinatal history examination findings are recorded in predesigned proforma. After 72 hrs and before 96 hrs of life blood was collected and sent for relevant investigations and clinical condition of the baby and urine out put was monitored and were managed accordingly. esults: Incidence of ARF in our study is 50 (50.0%) Among the 50 cases which had acute renal failure, 40 (80%) had pre-renal ARF and 10 (20%) had intrinsic ARF, and based on urine out put 15 (30.0%) had oliguric ARF and 35 (70.0%) had non oliguric ARF. Comparison of blood parameters among the cases with and without ARF showed that the renal parameters were raised in cases with ARF. Incidence of ARF correlated well with HIE staging. Among the 50 ARF cases 35 improved clinically after fluid therapy, 15 did not improve clinically after fluid therapy, 10 neonates died. Among the 10 neonates who died all 10 (10.0%) had oliguric ARF. Conclusions: Perinatal asphyxia is an important cause of neonatal renal failure. ARF in birth asphyxia is predominantly pre-renal ARF and responds to fluid challenge and it is of non oliguric type. ARF in birth asphyxia correlates well with HIE staging. Mortality is more in intrinsic ARF. Early diagnosis and management of renal failure helps in prevention of intrinsic renal failure and its consequences. A simple procedure like measuring urineoutput in birth asphyxia helps to detect intrinsic renal failure thereby preventing & reducing mortality.
Authors and Affiliations
CH. Archana
Keywords
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- EP ID EP572138
- DOI 10.21088/ijmfnm.2347.999X.5218.5
- Views 94
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