Renal Dysfunction in Perinatal Asphyxia & its Correlation with Apgar Score and Hypoxic Ischemic Encephalopathy Stage

Renal involvement is frequent in perinatal asphyxia. The severity of renal involvement and adverse outcome are correlated with severity of asphyxia and HIE stage. The study determined the incidence of renal failure after perinatal asphyxia, to assess comprehensively the renal functions of asphyxiated newborns and to correlate severity and type of renal failure with Apgar Score and HIE stage. This prospective cohort study was conducted on total 50 newborns of >34wks gestational age .All neonates were evaluated clinically and their renal functions were assessed on day 3 and 5. Assessment of fractional excretion of sodium (FeNa) was done to know the type of renal failure. Criteria for labeling an asphyxiated neonate as having renal failure were serum creatinine >1.5mg/dl or oliguria6hrs beyond first day of life.HIE staging was done by Sarnat and Sarnat staging system. Results were tabulated and analyzed statistically by student t test , Chi-Square test and Anova test. Acute renal failure was common among asphyxiated newborns with incidence of 57.5%.in our study. Incidence of renal failure increases as Apgar score decreases and as HIE stage progresses. Blood urea and serum creatinine were significantly higher in asphyxiated babies, compared to control group (p value 2.5) was more in severely asphyxiated and HIE stage-III babies. Predictors of adverse outcome are intrinsic renal failure, higher HIE stage and severe asphyxia