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Renal failure in asphyxiated neonates
B D Gupta1, Pramod Sharma, Jyoti Bagla
1Department of Pediatrics, Umaid Hospital for Women and Children, Dr. S.N. Medical College, Jodhpur, Rajasthan, India.
Indian Pediatrics
|October 7, 2005
Summary
Renal failure is common in neonates with birth asphyxia, often non-oliguric. Severity of kidney injury correlates with asphyxia severity, with oliguria and abnormal ultrasounds indicating poor prognosis.
Area of Science:
- Neonatal Medicine
- Pediatric Nephrology
- Perinatal Research
Background:
- Birth asphyxia is a critical condition in neonates.
- Neonatal kidney injury (NKI) is a significant complication of birth asphyxia.
- Understanding the incidence and characteristics of NKI is crucial for management.
Purpose of the Study:
- To determine the incidence of renal failure in neonates with birth asphyxia.
- To correlate renal failure severity and type with Apgar scores and hypoxic-ischemic encephalopathy (HIE) grading.
- To assess the prognostic significance of renal parameters and sonographic findings.
Main Methods:
- Prospective case-controlled study in a tertiary NICU.
- Enrolled 70 asphyxiated neonates and 28 healthy controls.
- Assessed renal function via urinary output, microscopy, biochemistry, and sonography.
Main Results:
- 47.1% of asphyxiated neonates developed renal failure, predominantly non-oliguric (78%).
- Biochemical derangements correlated with HIE staging and Apgar scores.
- Oliguria, hyponatremia, and abnormal sonographic findings were associated with poor prognosis and higher mortality.
Conclusions:
- Renal failure is a significant complication of birth asphyxia, with non-oliguric type being most common.
- Kidney injury severity correlates with the degree of asphyxia.
- Early identification of prognostic indicators like oliguria and sonographic abnormalities is vital for managing asphyxiated neonates.