DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20220092

Perinatal asphyxia and acute renal failure in neonates: presentation and outcomes

Azhar A. Khan, Anzeen N. Kanth, Aymen M. Khan, Suhail M. Khan, Owais A. Wani

Abstract


Background: Perinatal asphyxia (PNA) is described by the world health organization as a "failure to begin and sustain breathing at delivery." Acute renal failure (ARF), a well-known consequence of birth asphyxia, has a poor immediate prognosis and can leave survivors with lasting renal impairment. The goal of this study was to find out how often ARF is in cases of PNA and how it relates to the severity of the Apgar score and the grading of hypoxic ischemic encephalopathy.

Methods: This study was based on APGAR scores and a renal function evaluation done on day 3 of life on neonates with a gestational age of >34 weeks and signs of birth asphyxia.

Results: According to the APGAR score, 46 percent of the 75 infants investigated had mild PNA, whereas 42% and 12% of the babies had moderate and severe PNA. ARF was discovered in 24% of PNA patients, with oliguric renal failure (ORF) in 42% and non-ORF (NORF) in 58%. Blood urea was elevated in all instances with ARF (100%) but only 8% of non-ARF patients. ARF was found in 100% of individuals with severe PNA, but only 28% of patients with mild PNA. ARF was not found in any of the individuals with mild PNA. Only 3 (4%) of asphyxiated babies had abnormal renal USG results.

Conclusions: Our findings revealed a substantial link between PNA severity and ARF, with no ARF in mild PNA. The incidence of ARF and the stage of HIE were shown to have a linear association in this study. Only ORF instances resulted in death.


Keywords


PNA, APGAR, ARF, RIFLE

Full Text:

PDF

References


Perlman JM. Systemic abnormalities in term infants following perinatal asphyxia: relevance to long-term neurologic outcome. Clin Perinatol. 1989;16:475-84.

Wayenberg JL, Vermeylen D, Damis E. Definition of birth asphyxia and incidence of neurological and systemic complications in the term newborn. Arch Pediatr. 1998;5:1065-71.

Gunn AJ, Gluckman PD, Gunn TR. Selective head cooling in newborn infants after perinatal asphyxia: a safety study. Pediatrics. 1998;102:885-92.

Agras PI, Tarcan A, Baskin E. Acute renal failure in the neonatal period. Ren Fail. 2004;26:305-9.

Pejovic B, Peco-Antic A, Dunjic R. Acute oliguric renal failure in hypoxic neonates born at full term. Srp Arh Celok Lek. 2002;130:367-70.

Macher MA. Acute renal failure in children. EMC Pediatrics. 2004;1:73-88.

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

Jayashree G, Dutta AK, Sarna MS. Acute renal failure in asphyxiated newborns. Indian Pediatr. 1991;28:19-23.

Hauth JC, Merenstein GB. Guidelines of perinatal care, 4th edn. Elk Grove Village, IL American Academy of Paediatrics, and American Collage of Obstetrician and Gynaecologist. 1997;122-3.

Martin A, Alfredo GA, Francisco G and Fernando C. Multiple organ involvement in perinatal asphyxia. Pediatr. 1995;127(5):786-92.

Singh M. Care of the baby in labour room. In: Care of new-born, 5th Ed. New Delhi: Sagar publication. 1999;113-4.

World Health Organization. International classification of disease and related health problem, 10th ed. Available at: https://www.who.int/ classifications/icd/ICD10Volume2_en_2010.pdf. Accessed on 02 December 2021.

Sarnat HB, Sarnat MS. Neonatal encephalopathy following foetal distress: A clinical and Electroencephalographic study. Arch Neurol. 1976;33:695-706.

Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int. 2007;71:1028.

Pejovic B, Peco-Antic A, Dunjic R. Acute oliguric renal failure in hypoxic neonates born at full term. Srp Arh Celok Lek. 2002;130:367-70.

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

Karlowicz MG, Adelman RD. Nonoliguric and oliguric acute renal failure in asphyxiated term neonates. Pediatr Nephrol 1995; 9: 718–22.

Shah P, Riphagen S, Beyene J, et al. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal 2004; 89: F152–5.

Mishra PK, Kumar A, Natu SM, Kapoor RK, Srivastava KL, Das K. Renal failure insymptomatic perinatal asphyxia. Indian Pediatr. 1991;28:1147-51.

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