Study of incidence of acute kidney injury in asphyxiated neonates with hypoxic ischemic encephalopathy

Authors

  • Rita Chaudhary Department of Biochemistry, Patna Medical College, Patna, Bihar, India
  • Anil Kumar Tiwari Department of Pediatrics, Patna Medical College, Patna, Bihar, India
  • Farhan Usmani Department of Biochemistry, Patna Medical College, Patna, Bihar, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20204547

Keywords:

AKI, HIE, Perinatal asphyxia

Abstract

Background: Perinatal asphyxia causes multi organ dysfunction resulting in renal (50%) and neurological (28%) compromise with 1.4% of hypoxic ischemic encephalopathy (HIE) and almost 20% death in India. Early recognition of acute kidney injury (AKI) is important in babies with HIE to facilitate appropriate fluid and electrolyte management for a stable biochemical milieu is vital.

Methods: A prospective case control study was done in Patna Medical College and Hospital, Patna between January 2019 and March 2020. 70 term asphyxiated neonates with HIE as cases and 70 healthy neonates as control were taken. AKI on basis of p RIFLE criteria and HIE on the basis of 5 minute APGAR score were determined and correlated.

Results: 58.6%cases of AKI with 73% pre renal and 61% non-oliguric type were found in asphyxiated neonates with HIE blood urea and serum creatinine values were significantly higher in asphyxiated babies than control group babies (p<0.0001).

Conclusions: The extent of AKI is directly proportional to severity of HIE.

 

Author Biography

Rita Chaudhary, Department of Biochemistry, Patna Medical College, Patna, Bihar, India

Assistant Professor

Department of Pediatrics

Patna Medical College, Patna, Bihar, India 800004

References

Selewski DT, Cornell TT, Heung M, Troost JP, Ehrmann BJ, Lombel RM, et al. Validation of the KDIGO acute kidney injury criteria in a pediatric critical care population. Intens Care Med. 2014;40(10):1481-8.

Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32(4):260-7.

Perlman JM, Tack ED, Martin T, Shackelford G, Amon E. Acute systemic organ injury in term infants after asphyxia. Am J Dis Child. 1989;143:617-20.

Behrman RE, Lees MH, Peterson EN, De Lannoy CW, Seeds AE. Distribution of the circulation in the normal and asphyxiated fetal primate. Am J Obstet Gynecol. 1970;108:956-69.

Cohn HE, Sacks EJ, Heymann MA, Rudolph AM. Cardiovascular responses to hypoxemia and acidemiainfetal lambs. Am J Obstet Gynecol. 1974;120:817-24.

Rudolph AM. The fetal circulation and its response to stress. J Dev Physiol. 1984;6:11-9.

Perlman JM, Tack ED, Martin T, Shackelford G, Amon E. Acute systemic organ injury in term neonates after asphyxia. Am J Dis Child. 1989;143:617-20.

Snyder EY, Cloherty JP. Perinatal asphyxia. In: Cloherty JP, Stark Ann R, eds. Manual of Neonatal Care. 4th ed. Philadelphia: Lippincott-Raven Publishers; 1998:530.

Sutherland SM, Ji J, Sheikhi FH, Widen E, Tian L, Alexander SR, et al. AKI in hospitalized children: epidemiology and clinical associations in a national cohort. Clin J Am Soc Nephrol. 2013;8(10):1661-9.

NNPD network. National Neonatal Perinatal Database- report for the year 2002-2003. NNF NNPD network. New Delhi: 2005. Available from: https://www.newbornwhocc.org/pdf/nnpd_report_2002-03.PDF.

Gopal G. Acute kidney injury (AKI) in perinatal asphyxia. Indian J Pharm Biol Res. 2014;2:60-5.

Bairwa AL, Meena KC, Bhatnagar A. Incidence of acute kidney injury in perinatal asphyxia and its correlation with hypoxic ischemic encephalopathy (HIE) staging. Indian J Res. 2014;3:12-6.

Srivatsava RN, Arvind B. Pediatric nephrology. 6th ed. New Delhi: Jaypee Publishers; 2016:538-541.

Kliegman RM, Stanton BF, St Geme JW 3rd, Schor NF. Nelson Textbook of Pediatrics. 20th edn. New Delhi: Elsevier; 2015:2539-2542.

Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. The incidence of renal failure in asphyxiated neonates and to correlate severity and type of renal failure with Apgar score and hypoxic ischemic encephalopathy (HIE) grading of the neonates. Indian Pediatr. 2005;42:928-34.

Karlowicz M, Adelman R. Nonoliguric and oliguric acute renal failure in asphyxiated term neonates. Pediatr Nephrol. 1995;9:718-22.

Martin-Ancel A, Garcia-Alix A, Gaya F. Multiple organ involvement in perinatal asphyxia. J Pediatr. 1995;127:786-93.

Carter B, McNabb F. Prospective validation of a scoring system for predicting neonatal morbidity after acute perinatal asphyxia. J Pediatr. 1998;132:619-23.

Adams-Chapman I, Stoll B. Nervous system disorders. In: Kliegman R, Behrman R, Jenson H, Stanton BF, eds. Nelson textbook of paediatrics. 18th edn. Philadelphia: WB Saunders; 2007:718.

Sarnat HB, Flores‐Sarnat L. Integrative classification of morphology and molecular genetics in central nervous system malformations. Am J Med Genet. 2004;126(4):386-92.

Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute Dialysis Quality Initiative workgroup. Acute renal failure- definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8:R204-12.

Durkan AM, Alexander TR. Acute kidney injury post neonatal asphyxia. J Pediatr. 2011;158(2):e29-33.

Aggarwal A, Kumar P, Chowdary G, Majumdar S. Neonates. J Trop Pediatr. 2005;51(5):295-9.

Jayashree G, Dutta AK, Sarna MS. Acute renal failure in asphyxiated newborns. Indian Pediatr. 1991;289(1):19-23.

Mohan PV, Pai PM. Renal insult in asphyxia neonatorum. Indian Pediatr. 2000;37(10):1102.

Agrawal S, Chaudhuri PK, Chaudhary AK, Kumar D. Acute kidney injury in asphyxiated neonates and its correlation to hypoxic ischemic encephalopathy staging. Indian J Child Health. 2016;3(3):254.

Medani SA, Kheir AEM, Mohamed MB. Acute kidney injury in asphyxiated neonates admitted to a tertiary neonatal unit in Sudan. Sudan J Paediatr. 2014;14(2):29-34.

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Published

2020-10-21

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Original Research Articles