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Evaluation of renal function in term babies with perinatal asphyxia
Jayom Karlo1, B Vishnu Bhat, B C Koner
1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India.
Indian Journal of Pediatrics
|June 11, 2013
Summary
Perinatal asphyxia frequently causes acute kidney injury in newborns. Fractional excretion of sodium (FENa), Renal Failure Index (RFI), and urinary β2 microglobulin (β2M) effectively assess kidney function and tubular injury.
Area of Science:
- Neonatal Medicine
- Pediatric Nephrology
- Critical Care
Background:
- Perinatal asphyxia is a significant cause of neonatal morbidity and mortality.
- Renal dysfunction is a common complication following perinatal asphyxia, impacting outcomes.
- Early and accurate assessment of renal function is crucial for timely intervention.
Purpose of the Study:
- To investigate renal function in term newborns experiencing perinatal asphyxia.
- To evaluate the utility of urinary β2 microglobulin (β2M) as a biomarker for renal injury.
- To assess the correlation between asphyxia severity and renal parameters.
Main Methods:
- A case-control study involving 50 term newborns with perinatal asphyxia and 50 controls.
- Assessment of asphyxia severity using Apgar scores and Hypoxic Ischemic Encephalopathy (HIE) staging.
- Measurement of serum and urinary parameters, including β2M, Fractional Excretion of Sodium (FENa), and Renal Failure Index (RFI).
Main Results:
- Acute Kidney Injury (AKI) was observed in 56% of cases, with 32% being intrinsic type.
- Serum urea and creatinine showed better correlation with renal function than urine parameters.
- FENa, RFI, and urinary β2M levels increased with the severity of asphyxia and HIE staging.
Conclusions:
- AKI is a prevalent complication in term newborns with perinatal asphyxia.
- FENa and RFI are valuable for assessing renal function in this population.
- Urinary β2M serves as a sensitive biomarker for diagnosing and predicting acute tubular injury in neonates with perinatal asphyxia.
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