Study of kidney function in asphyxiated full term newborn

ABSTRACT

Renal impairment in the neonates usually occurs following complicated labor and delivery with perinatal asphyxia, and it is usually in form of tubular insult. [Al Fred, 1996]. The clinical presentations of renal impairment in neonates is often subtle, lack of recognition of its occurrence has made this especially true when renal impairment follows perinatal asphyxia. To study kidney function in full term asphyxiated neonates. 24 asphyxiated FT newborn and 12 control were subjected to comprehensive history and renal function evaluation study. Routine urinalysis of cases, with perinatal hypoxia revealed proteinuria in 41.7% in patients. Many epithelial cells were found in 53.5% of the cases with perinatal asphyxia. Mean urine analysis for R.B.Cs of patients [6.33 RBCs/HPF +/- 4.02 RBCs/HPF]' which was significantly higher than that of controls [4.16 RBCs/HPF +/- 2.69 RBCs/HPF]. Mean urine analysis for pus cells of patients [2.84 pus cells/HPF +/- 1.59 pus cells/HPF] which was not significantly different than that of controls [3.08 pus cells/HPF + 3.87 pus cells/HPF]. Mean urinary beta 2 micro globulin concentration in patients [218.30 ng/ml +/- 100.93 ng/ml] was significantly higher than that of controls [144.316 ng/ml +/- 126.3 ng/ml] which is specific for tubular renal insult in renal impairment. Mean urinary urea in patients was [7.727 + 3.16 meq/l] which was not significant in relation to controls 96.80 +2.907 meq/l]. Mean urinary creatinine in patients was [1.30 +1.4 meq/l] which was not significantly different than controls [1.22 +1.09 meq/l]. Renal function must be evaluated in all asphyxiated newborn serum cratinine and heamaturia are sensitive indicators while urinary beta2 microlobin is more specific