Urinary uric acid or urinary creatinine ratio as a non-invasive marker for perinatal asphyxia

Background: Perinatal asphyxia is amongst the common problem of neonates and there exists a significant contribution to the neonatal morbidity and mortality. It is observed as a common and a vital cause of the preventable cerebral injury. The prediction of the perinatal asphyxial outcome is very important but dreadful. There is a limited role for APGAR score to predict the immediate outcome, like HIE and the long-term neurological sequelae observational error may happen in APGAR. But the biochemical parameters can truly be relied upon. This study was done to assess urinary uric acid/urinary creatinine ratio (UA/Cr) as a non-invasive marker for perinatal asphyxia and co-relate its absolute value to the degree of the perinatal asphyxia.Methods: In this prospective case control study conducted in the Pediatrics Department of Shri Ram Murti Smarak Institute of Medical Sciences between Nov 2017 to May 2019, 42 asphyxiated and 42 non-asphyxiated newborns were included. Detailed history and assessment were for all the enrolled newborns. Spot urine samples were sent for the uric acid and creatinine estimation. Results were documented, and statistical analysis was performed.Results: Urinary uric acid to creatinine ratio used as additional non-invasive, early and easy biochemical marker of the birth asphyxia that biochemically supports severity grading and clinical diagnosis of the asphyxia by APGAR score.Conclusions: The ratio of the urinary uric acid and creatinine enables rapid and early recognition of asphyxial injury and also the evaluation of its severity and potential for short-term morbidity or death.

Study of urinary uric acid and creatinine ratio as a marker for perinatal asphyxia

Background: Perinatal asphyxia refers to an impairment of the normal oxygenation during parturition and the ensuing adverse effects on the fetus/neonate.' In India, due to birth asphyxia, between 250,000 to 350,000 infants die each year, mostly within the first three days of life. Low APGAR score is commonly used to as a indicator of asphyxia in infants, but it may often be not available and may be reduced in premature infants. In present study we evaluated urinary uric acid and creatinine ratio as a marker for perinatal asphyxia, at our tertiary care hospital.Methods: Present study was a observational, case-control study, conducted in department of paediatrics, in case group consisted of 40 full-term neonates who were hospitalized with the diagnosis of perinatal asphyxia. The control group consisted of 40 healthy full-term newborns.Results: Male to female ratio was 1.5:1 in case group as compared to 1.22:1 in control group. Mean gestational age in case group was 286'10.32 days, while in control group it was 274'7.310 days. Mean birth weight was 2.72'0.51 kg & 2.88'0.49 kg in case & control group respectively. In 52.5 % neonates from case group, signs of intrapartum fetal distress were noted. A statistically significant difference (p<0.005) was noted in Apgar 5 min, Arterial blood pH, pO2 (mm Hg), pCO2 (mm Hg), Urinary uric acid (mg/dl) and Urinary uric acid/ creatinine ratio. Authors did not noted any significant difference in Urinary creatinine (mg/dl) values of cases and control group. Urinary UA/CR ratio is significantly higher in case group when compared with control group with t=11.19; P<0.001.Conclusions: The ratio of urinary uric acid to creatinine helps in rapidly recognizing asphyxia and assessing its severity, so it can be a good, simple screening test for early assessment of neonatal asphyxia.

Study on Anti-hyperuricemia Effect of Geniposide / 世界科学技术-中医药现代化

This article was aimed to study the effect of geniposide in hyperuricemia mice. Different doses (50, 100, 200 mg·kg-1) of geniposide were administrated to hyperuricemia mice induced by potassium oxonate by gavage for seven consecutive days. Then, serum uric acid (SUA), urinary uric acid (UUA) and the hepatic xanthine oxidase ac-tivities (XOD) of mice were detected. The results showed that the middle- and high-dose groups of geniposide re-duced the level of SUA significantly (P<0.01). It was concluded that geniposide can reduce the level of SUA in hy-peruricemia mice by promoting UUA excretion.

Biochemical Markers in Perinatal Asphyxia.

Early assessment of the severity of an acute cerebral lesion secondary to hypoxia-ischemia or other pathologic conditions may provide a very useful basis for preventive or therapeutic decisions in pediatric patients. In the present review, we discuss the diagnostic and prognostic value of a series of biochemical parameters, with special reference to the diagnosis of neonatal HIE. Currently many specific biochemical markers of brain injury are being investigated to assess regional brain damage after perinatal asphyxia in neonates of which serum protein S-100β, brain-specific creatine kinase, neuron-specific enolase, IL6 and urinary uric acid levels appear promising in identifying patients with a risk of developing hypoxic-ischemic encephalopathy. Whether detection of elevated serum concentrations of these proteins reflects long-term neurodevelopmental impairment remains to be investigated.

Urinary uric acid in preterm neonates.

Objective. Study of uric acid level in spot urine of normal preterm AGA (appropriate for gestational age) babies in day one of their life. Methods. Spot urine samples were collected from 45 normal preterm neonates within 24 hours of their birth for estimation of uric acid. Results. The mean uric acid level was 36.50 ± 5.99 mg/dl in normal preterm neonates as compared to 18.40 ± 0.45 mg/dl in normal term babies (documented in another study) (p < 0.001). Also a significant negative linear correlation between body weight and urinary uric acid level was found { r (correlation coefficient) = – 0.970, P (probability) < 0.001}. Conclusion. Higher mean uric acid level was found in spot urine samples of preterm normal neonates than that of normal term babies on day one. Further, urinary uric acid levels were found inversely proportional to the body weight or to the gestational age (as they are AGA) of the babies.

Study on Serum and Urinary Uric Acid Level in Patients with Urinary Stone / 대한비뇨기과학회지

Currently, uric acid disorders, especially including hyperuricosuria, are thought to be important in the formation Of idiopathic calcium urolithiasis. Herein, we estimated the serum concentration and urinary excretion of uric acid in I22 stone-formers, comparing to those in 56 controls. Also, various theories about the pathogenesis of uric acid disorder and stone formation were discussed. The results were as follows: 1. Serum uric acid levels of stone-formers were significantly higher than those of controls, in total and female, but, not in male. 2. Urinary uric acid levels of stone-formers were significantly higher than those of controls in total, male and female. 3. Hyperuricemia was significantly more frequent for stone-formers in total, male and female. 4. Hyperuricosuria was significantly more frequent for stone-formers in total, but, not significantly more frequent for stone-formers in male and female. 5. The incidence of stone-formers, in whom hyperuricemia and hyperuricosuria were not present at the sometime, was significantly less than that Of controls. These results suggest the possibility that uric acid disorder may play some roles in the genesis of urinary stone.