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Renal failure in symptomatic perinatal asphyxia.

P K Misra1, A Kumar, S M Natu

  • 1Department of Pediatrics, K.G. Medical College, Lucknow.

Indian Pediatrics
|October 1, 1991
PubMed
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Perinatal asphyxia can cause acute renal failure in newborns, characterized by low urine output and high potassium levels. This intrinsic kidney disease in neonates is associated with a high mortality rate.

Area of Science:

  • Neonatal Medicine
  • Pediatric Nephrology
  • Critical Care

Background:

  • Perinatal asphyxia is a significant cause of neonatal morbidity.
  • Acute renal failure (ARF) in neonates presents unique diagnostic and management challenges.
  • Intrinsic renal disease can be a severe complication of hypoxic-ischemic events.

Purpose of the Study:

  • To investigate the clinical and biochemical characteristics of acute renal failure in term newborns with perinatal asphyxia.
  • To identify indicators of intrinsic renal disease in this vulnerable population.
  • To highlight the mortality associated with this condition.

Main Methods:

  • Retrospective analysis of seven term newborns with symptomatic perinatal asphyxia.
  • Evaluation of clinical data including urinary output.

Related Experiment Videos

  • Biochemical assessments: serum and urinary electrolytes (sodium, potassium), creatinine, blood urea nitrogen, fractional excretion of sodium (FeNa), and renal failure index (RFI).

    • Main Results:

    • All patients presented with oliguria unresponsive to fluid challenges or diuretics.
    • Elevated serum potassium (K) was observed in all cases.
    • Diagnostic indices indicated intrinsic renal disease: FeNa > 2.5% and RFI > 3.
    • The condition was associated with a very high mortality rate.

    Conclusions:

    • Symptomatic perinatal asphyxia frequently leads to intrinsic acute renal failure in term newborns.
    • Oliguria, hyperkalemia, elevated FeNa, and RFI are key indicators of renal injury.
    • This condition carries a grave prognosis with substantial mortality in the neonatal period.