Renal involvement in term neonates with Hypoxic-Ischemic Encephalopathy: A frequency-based study.

Abstract

Objective: The objective of this study was to determine the frequency of acute renal failure in term neonates presenting with hypoxic ischemic encephalopathy.
Methodology: This cross-sectional study conducted at PAF Hospital Mushaf Sargodha from 01-01-2025 to 31-06-2025. During study period 159 full term neonates of both gender having APGAR score <7 at 5 minutes after birth were recruit-ed. A written informed consent was taken from parents of every patient. All grades of birth asphyxia were included. Se-rum creatinine was acquired after 72 hours of birth and acute renal failure was diagnosed if it was ≥1.5mg/dl.
Results: The mean gestational age of the neonates was 39.54±1.83 weeks. 85 (53.5%). The male to female ratio was 1.8:1. Majority (n=110,69.2%) of the neonates were delivered by spontaneous vaginal delivery (SVD) while 49 (30.8%) were delivered by C-section. The mean weight of the neonates was 2.62±0.52 kg. 50 (31.5%) neonates had mild, 90 (56.6%) neonates had moderate and 19 (11.9%) neonates had severe birth asphyxia. Mean blood urea level was 29.6±5.8 mg/dl while mean serum creatinine level was 1.77±0.53 mg/dl. Acute renal failure was observed in 101 (63.5%) neonates. The frequency of ARF increased significantly with increasing severity of birth asphyxia, mild vs mod-erate vs severe (20% vs 76.7% vs 100%; p<0.001). However, there was no significant difference across gestational age, gender, mode of delivery and birth weight.
Conclusion: A significant percentage of asphyxiated newborns experienced acute renal failure, which was linked to the severity of birth asphyxia. This calls for routine monitoring of asphyxiated neonates in order to promptly detect and treat this problem in future practice to improve the result.

Keywords: Birth Asphyxia, Sarnat Grading, Acute Renal failure.