Incidence of Acute Renal Failure (ARF) in Birth Asphyxia and its Correlation with Hypoxic Ischemic Encephalopathy (HIE) Staging
Introduction: Acute kidney injury (AKI) previously known as Acute renal failure is a recognized complication of neonates with perinatal asphyxia. In all asphyxiated neonates emphasis must be laid on early recognition of AKF, so that it paves a way for timely and appropriately management thereby p...
Main Authors: | , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Pvt. Ltd.
2016-04-01
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Series: | Indian Journal of Neonatal Medicine and Research |
Subjects: | |
Online Access: | http://www.ijnmr.net/articles/PDF/2118/1-%2018312_F(P)_PF1(Vsu_Om)_PFA(Om)_PF2(PVSU).pdf |
Summary: | Introduction: Acute kidney injury (AKI) previously
known as Acute renal failure is a recognized complication of neonates with perinatal asphyxia. In all asphyxiated neonates emphasis must be laid on early
recognition of AKF, so that it paves a way for timely
and appropriately management thereby preventing
consequences of irreversible renal failure.
Aim: To determine the incidence of Acute renal
failure in birth asphyxia and to correlate the severity
of renal failure with and HIE grading of asphyxiated
neonates.
Materials and Methods: A case control study was
conducted for a period of 1 year, where 100 term
(37-42 wks) neonates born with Apgar score of 7/<7
at 5 minutes after birth were selected as cases and
50 normal term (37-42 wks) neonates as controls.
Sarnat and Sarnat staging was used for HIE. After 72
hrs and before 96 hrs of life blood was collected and
sent for relevant investigations and clinical condition
of the baby and urine output was monitored and
data was collected in predesigned proforma after
informed consent.
Results: Incidence of ARF is significantly more in
cases (75.0% vs. 4.0%) 18.4 times more likely when
compared to controls. Among the 75 cases which
had acute renal failure , 64 (85.3%) had pre-renal
ARF and 11(14.6%) had intrinsic ARF , and based
on urine output 24 (32.0%) had oliguric ARF and
51 (68.0%) had non oliguric ARF and among the 50
controls 2 neonates had pre-renal and non-oliguric
type of ARF. Incidence of ARF had a strong correlation
with HIE staging.
Conclusion: ARF in birth asphyxia is predominantly
pre-renal ARF and responds to fluid challenge and it is
of non oliguric type. ARF in birth asphyxia correlates
well with HIE staging. Mortality is more in intrinsic
ARF. Early diagnosis and management of renal failure
helps in prevention of intrinsic renal failure and its
consequences. |
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ISSN: | 2277-8527 2455-6890 |