The Correlation between the Severity of Hypoxic Ischemic Encephalopathy and the Development of Acute Renal Failure in Asphyxiated Neonates.
- Author:
Sung Shin PARK
1
;
Sung Hoon CHUNG
;
Jun Hyuk SONG
;
Sun Kyoung KIM
;
Sung Do KIM
;
Byoung Soo CHO
Author Information
1. Department of Pediatrics, Kyung-Hee University Hospital, Seoul, Korea. kimsungdo@empal.com
- Publication Type:Original Article
- Keywords:
Asphyxia;
Acute renal failure;
Hypoxic ischemic encephalopathy
- MeSH:
Acute Kidney Injury*;
Apgar Score;
Asphyxia;
Blood Urea Nitrogen;
Creatinine;
Electrolytes;
Humans;
Hypoxia-Ischemia, Brain*;
Incidence;
Infant, Newborn*;
Medical Records;
Mortality;
Parturition;
Prognosis;
Renal Insufficiency;
Retrospective Studies
- From:Journal of the Korean Society of Pediatric Nephrology
2007;11(1):32-40
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We performed this study to determine the incidence of acute renal failure(ARF) in birth asphyxia and to correlate the severity of asphyxia and hypoxic-ischemic encephalopathy (HIE) and ARF in asphyxiated neonates. METHODS: Data was retrospectively collected from the medical records of 33 patients with neonatal asphyxia and of 33 neonates with no asphyxia. On the basis the 5-minute Apgar score, the asphyxiated neonates were further grouped into mild(6 or 7), moderate(4 or 5), and severe asphyxia(3 or less). Asphyxiated neonates with HIE were staged by the Sarnat and Sarnat scoring system. We compared serum creatinine, blood urea nitrogen, electrolytes, and urine output on day 3 of life and the incidence and severity of intraventricular hemorrhage(IVH) between each group. RESULTS: ARF occurred in 8(24.2%) asphyxiated neonates. Of these, 3(37.5%) were oliguric, while 1(10.0%) patient with mild asphyxia, 2(18.2%) of moderate asphyxia, and 5(41.7%) with of severe asphyxia had ARF(P>0.05). One(25%) patient with stage I HIE, 4(50%) with stage II HIE, and 3(75%) of HIE with stage III HIE developed ARF(P<0.01). There was no statistical correlation between the severity of asphyxia and HIE stage. One(7.7%) patient with grade 1 IVE, 0(0.0%) with grade 2 IVH, 2(66.7%) with grade 3 IVH, and 2(100.0%) with grade 4 IVH had ARF(P<0.01). Mortality was higher in asphyxiated neonates with ARF(P<0.05). There was no significant difference between the oliguric and non-oliguric renal failure. CONCLUSION: We found that the greater the degree of HIE, the higher was the incidence of ARF. Asphyxiated neonates with ARF had a poorer prognosis.
