Acute Kidney Injury in Perinatal Asphyxia: Comparison Between Term and Preterm Neonates

Abstract

Objective: To investigate asphyxiated neonates for acute kidney injury, compare the occurrence between preterms and terms and to correlate the severity and type of renal injury with the degree of asphyxia and hypoxic ischemic encephalopathy (HIE) grading. Materials and Methods: Renal functions were assessed using urine output and biochemical parameters such as blood urea, serum creatinine, serum sodium, potassium, and calcium. These were evaluated on alternate days till day 7 or recovery or death. Results: Total 108 asphyxiated neonates were enrolled: 63 term and 45 preterm. A total of 28 (25.9%) developed acute kidney injury: 9 (32.1%) had oliguric acute renal injury and the rest 19 (67.8%) had nonoliguric acute renal injury. A total of 77.7% neonates had a prerenal cause and the other 22.2% had an intrinsic cause for the kidney injury. Levels of blood urea and serum creatinine were maximally elevated on day 5 of life. Biochemical derangements correlated well with the Apgar score at birth and severity of HIE. No statistically significant difference was observed in the incidence of renal injury between preterm and term asphyxiated neonates. Conclusion: Perinatal asphyxia is an important cause of renal injury in neonates. A majority of neonates had nonoliguric and pre renal type of acute kidney injury. The more severe the degree of asphyxia, the more prone they were to develop renal complications.

Frequency of Acute Kidney Injury with Hypoxic Ischemic Encephalopathy Staging in Neonates with Perinatal Asphyxia: An Observational Study (Descriptive Case Series)

“…The neonatal kidney is anatomically, functionally immature and has been defined as 'halfway to acute kidney failure'. Renal insufficiency may develop as early as 24 hours of life, leading to un-repairable cortical damage when hypoxia is prolonged [4,5,6]. The incidence of perinatal asphyxia and its severity matchup with increasing incidence of acute kidney injury [7].…”