Published: 2022-06-23

Evaluation of renal function among term neonates with perinatal asphyxia

Arvind Sood, Arunima Bhardwaj, Surinder Singh, Jagjit Singh Chahal


Background:  Perinatal asphyxia is a significant cause of morbidity and mortality amongst neonates in developing countries. The incidence of perinatal asphyxia in developed countries is 2 per 1000 live births, but the rate is 10 times higher in developing countries due to inadequate access to neonatal and maternal care. Among neonates with HIE, it is difficult to predict which newborn will develop renal dysfunction so there is urgent need for publication about relations of severity of HIE and renal dysfunction

Methods: This prospective case control study was conducted on 50 term neonates as cases and 50 term neonates in control group. Neonates in case groups were diagnosed according to WHO definition of HIE and age and sex matching of babies were done. Serum creatinine was measured one baseline and another after 48 hours of life.

Results: The study shows mean maternal age 25.24±4.65 in the cases and 27.44±4.17 in control group, gravida of 1.64±0.89, 1.60±0.78 in case and control group, APGAR score at 1 minute & 5minutes 3.40±1.34, 5.62±1.55 in cases and 7.0±0.0, 9.0±0.0 in control group which is statistically significant (p<0.001). Among cases 78% had moderate birth asphyxia and 22% had severe perinatal asphyxia. Among cases 62% (31/50) babies developed AKI and among cases with AKI 20 (62.5%) developed prerenal AKI and 37.5% (12/31) developed intrinsic AKI.

Conclusions: The detection renal dysfunction at an early stage can help in early intervention and prevention of irreversible renal damage and thus, will improve overall survival of these asphyxiated neonates. Serum creatinine levels correlates with severity of HIE.


AKI, Fractional excretion of sodium, RFI, Hhypoxic ischemic encephalopathy

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National Neonatal-Perinatal Database. Available at: Accessed on 23 November 2021.

Odd D, Heep A, Luyt K, Draycott T. Hypoxic-ischemic brain injury: Planned delivery before intrapartum events. J Neonat Perinat Med. 2017; 10(4):347-53.

Carter BS, McNabb F, Merenstein GB. Prospective validation of a scoring system for predicting neonatal morbidity after acute perinatal asphyxia. J Pediatr. 1998;132(4):619-23.

Agarwal R, Deorari A, Paul V. AIIMS protocol in neonatology. 2nd ed. United States of America: Elsevier; 2019;419.

Eichenwald E, Hansen A. Cloherty and Stark’s Manual of Neonatal Care. 7th ed. USA: Lippincott Williams & Wilkins; 2010.

Brezis M, Rosen S. Hypoxia of the renal medulla its implications for disease. N Engl J Med. 1995; 332(10):647-55.

Barry B, Brenner M. Harrisons principles of internal medicine. in: Harrisons principles of internal medicine. 16th ed. 2005;1644-6.

Aggarwal A, Kumar P, Chowdhary G, Majumdar S, Narang A. Evaluation of renal functions in asphyxiated newborns. J Trop Pediatr. 2005;51(5): 295-9.

Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. Renal failure in asphyxiated neonates. Indian Pediatr. 2005;42(9):928-34.

Rai S, Singh N. Renal Status in Birth Asphyxia. J Trop Pediatr. 2016;3(5):3.

Chaudhary R, Tiwari AK, Usmani F. Study of incidence of acute kidney injury in asphyxiated neonates with hypoxic ischemic encephalopathy. Int J Contemp Pediatr. 2020;7(11):2205-9.