Renal function in full-term newborns following neonatal asphyxia. A prospective study

Area of Science:

• Neonatology
• Pediatric Nephrology
• Perinatal Medicine

Background:

• Neonatal asphyxia is a significant cause of infant mortality and morbidity.
• Renal function alterations are a potential complication following perinatal asphyxia.
• Early identification and management of renal dysfunction are crucial for improving outcomes.

Purpose of the Study:

• To evaluate renal function in term infants suffering from neonatal asphyxia.
• To assess the impact of asphyxia on kidney function during the early neonatal period.
• To investigate the response to interventions for oliguria in asphyxiated newborns.

Main Methods:

• Prospective study comparing 21 asphyxiated newborns with 20 controls.
• Assessment of renal function between 24-48 hours (Period I) and 48-72 hours (Period II) for the asphyxiated group.
• Oliguria ( < 1 ml/Kg/h for >12 hours) prompted volume challenge and diuretic use.

Main Results:

• Two cases of intrinsic acute renal failure were diagnosed in the asphyxiated group, with one mortality.
• Ten infants with prerenal oliguria showed prompt improvement after volume expansion and diuretic administration.
• Nine infants exhibited persistent oliguria, with renal function parameters comparable to controls.

Conclusions:

• Neonatal asphyxia can lead to acute kidney injury, including intrinsic renal failure.
• Prerenal oliguria in asphyxiated neonates often responds well to fluid resuscitation.
• Renal function monitoring is essential in term infants with neonatal asphyxia to guide management and predict outcomes.