Acute renal failure in jaundiced-isoimmunized full term neonate

ABSTRACT

This study included 85 full-term newborns with unconjugated hyperbilirubinemia, due to ABO and RH incompatibility and renal impairment as well as 20 healthy, age and sex matched full-term newborns as a control group. None of the cases showed any stress factors which may cause renal failure. All cases were subjected to full clinical examination, abdominal ultrasonography to exclude cases with congenital renal abnormalities, laboratory investigations of blood were done at the 5th day then repeated at 30th day of postnatal life for follow up. According to the investigations, the patients were subdivided into 2 groups 25 patients with acute renal failure [ARF] and 60 patients without acute renal failure [non ARF]. They represent 4.2% and 10.1%, respectively. of the total admissions of the jaundiced, isoimmunized full-term newborns in the NICU in one year [596 neonates]. Follow up studies for one month revealed that renal functions were normalized in cases with non-ARF except the beta 2 microglobulin, while cases with ARF still have significantly higher differences in all the studied parameters when compared to the control group after one month except for urine pH and specific gravity. In conclusion, renal impairment should be expected in cases having total serum bilirubin >25 mg/dL. They should be closely monitored regarding their renal functions for at least one month of postnatal life. Those who develop ARF should be followed up for a longer period