INCIDENCE AND OUTCOME OF ACUTE RENAL FAILURE IN NEONATES WITH PERINATAL ASPHYXIA AND ITS CORRELATION WITH APGAR SCORE AND HYPOXIC ISCHEMIC ENCEPHALOPATHY GRADING

*Sandeep Banga, Mukhtiar Singh Pannu, Sahab Ram, Palveen, Showkat Hussain Talli and Harijot Singh Bhattal

ABSTRACT

Background: World Health Organization has defined perinatal asphyxia (PNA) as a “failure to initiate and sustain breathing at birth.” Acute renal failure a recognized complication of birth asphyxia, carries poor immediate prognosis and may result in permanent renal damage in survivors. Objectives: To determine the incidence of Acute Renal Failure in cases of Perinatal Asphyxia and to correlate it with severity of Apgar score and Hypoxic Ischemic Encephalopathy grading. Methods: this study is done on newborns with gestational age >34 weeks having evidence of birth asphyxia based on APGAR scores and renal function assessment done at day 3 of life. Results: among 50 newborns studied, 46 Forty six percent patients had mild PNA where as 42 % patients & 12% patients were having moderate & severe PNA based on APGAR score. ARF was found in 24% cases of PNA with oliguric renal failure (ORF) in 42% and non oliguric renal failure (NORF) in 58% cases. All cases of ARF (100%) had raised blood urea while it was raised only in 8% of non ARF cases. All patients of severe PNA (100%) had ARF whereas only 28% patients of moderate PNA had ARF. None of patients with mild PNA had ARF. Renal USG showed abnormalities in only 2 (4%) asphyxiated newborns. Conclusions: Our results showed a strong relation between severity of PNA and ARF, with no ARF seen in mild PNA.This study showed a linear relationship between incidence of ARF and staging of HIE. Mortality occurred in ORF cases only.

Keywords: Acute Renal failure in newborns, HIE, PNA.