Evaluation of renal function in term babies with perinatal asphyxia. 2014

Jayom Karlo, and B Vishnu Bhat, and B C Koner, and B Adhisivam
Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India.

OBJECTIVE To study the renal function in term newborns with perinatal asphyxia including urinary excretion of β2 microglobulin (β2M). METHODS This case control study included 50 term newborn babies with perinatal asphyxia and 50 normal babies as matched controls. In all cases, asphyxia grading (using Apgar score) and Hypoxic ischemic encephalopathy (HIE) staging (Sarnat and Sarnat) were done. Blood and urinary parameters (including β2M) for renal function were done in all and Fractional excretion of sodium (FENa) and Renal failure index (RFI) were calculated. The renal parameters were compared within subgroups as well as controls using analysis of variance test and the independent samples t test. RESULTS Acute kidney Injury (AKI) was noted in 56 % of cases (24 % prerenal and 32 % intrinsic type). All 9 babies who died had AKI. Serum parameters like urea, creatinine, sodium and potassium had better correlation with the renal function as compared to urine parameters. All individual urine parameters except β2M showed wide variations. FENa, RFI and urinary β2M increased with increasing severity of asphyxia and HIE staging. CONCLUSIONS AKI is common in term babies with perinatal asphyxia. FENa and RFI are useful parameters for assessing the renal function and urinary β2M is a good biomarker for diagnosis and prognosis of acute tubular injury in term babies with perinatal asphyxia.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001238 Asphyxia Neonatorum Respiratory failure in the newborn. (Dorland, 27th ed)
D016022 Case-Control Studies Comparisons that start with the identification of persons with the disease or outcome of interest and a control (comparison, referent) group without the disease or outcome of interest. The relationship of an attribute is examined by comparing both groups with regard to the frequency or levels of outcome over time. Case-Base Studies,Case-Comparison Studies,Case-Referent Studies,Matched Case-Control Studies,Nested Case-Control Studies,Case Control Studies,Case-Compeer Studies,Case-Referrent Studies,Case Base Studies,Case Comparison Studies,Case Control Study,Case Referent Studies,Case Referrent Studies,Case-Comparison Study,Case-Control Studies, Matched,Case-Control Studies, Nested,Case-Control Study,Case-Control Study, Matched,Case-Control Study, Nested,Case-Referent Study,Case-Referrent Study,Matched Case Control Studies,Matched Case-Control Study,Nested Case Control Studies,Nested Case-Control Study,Studies, Case Control,Studies, Case-Base,Studies, Case-Comparison,Studies, Case-Compeer,Studies, Case-Control,Studies, Case-Referent,Studies, Case-Referrent,Studies, Matched Case-Control,Studies, Nested Case-Control,Study, Case Control,Study, Case-Comparison,Study, Case-Control,Study, Case-Referent,Study, Case-Referrent,Study, Matched Case-Control,Study, Nested Case-Control
D058186 Acute Kidney Injury Abrupt reduction in kidney function. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions. Acute Kidney Failure,Acute Kidney Insufficiency,Acute Renal Failure,Acute Renal Injury,Acute Renal Insufficiency,Kidney Failure, Acute,Kidney Insufficiency, Acute,Renal Failure, Acute,Renal Insufficiency, Acute,Acute Kidney Failures,Acute Kidney Injuries,Acute Kidney Insufficiencies,Acute Renal Failures,Acute Renal Injuries,Acute Renal Insufficiencies,Kidney Failures, Acute,Kidney Injuries, Acute,Kidney Injury, Acute,Kidney Insufficiencies, Acute,Renal Failures, Acute,Renal Injuries, Acute,Renal Injury, Acute,Renal Insufficiencies, Acute

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