Impairment of Renal Function and Dyselectrolytemia in Perinatal Asphyxia

Abstract

Background: Perinatal asphyxia is one of the major causes of neonatal death and disabilityworldwide. Asphyxiated newborns are vulnerable to develop impaired renal functions andderangement in electrolytes level.Objective: To determine the effects of perinatal asphyxia on renal functions and serumelectrolytes.Methods: This cross sectional observational study was conducted at inpatient department ofPaediatrics of Rangpur Medical College Hospital from May 2017to October 2017. After parentalpermission and clearance, total 200 eligible hospitalized term neonates fulfilling the inclusionand exclusion criteria were enrolled into the study. Estimation of serum creatinine, blood urea,serum sodium and potassium were done for every neonate after hospitalization. Data collectionand processing were done for each patient. Data were analyzed through SPSS software (version16.0). Level of significance was predetermined as p<0.05.Results: Analysis revealed that out of 200 neonates 130(65%) patients were in Hypoxic IshchemicEncephalopathy stage-ll followed by 50(25%) and 20(10%) patients in stage-lll and stage-lrespectively. Of total subjects, 68(34%) neonates had raised serum creatinine (p<0.001) andmajority (36 cases out of 50,18% of total) of them were in stage-lll. Blood urea wasraised(p<0.001) in more than half (112 cases out of 200, 56% of total neonates) of the asphyxiatedneonates, higher level was observed in stage-ll and stage-lll. Majority of asphyxiated neonates139(69.5%) were hyponatremic which was significant in all stages of birth asphyxia (p=0.026).Hyperkalemia observed in 38(19%) asphyxiated neonates which was significant with increasedseverity of perinatal asphyxia (p=0.007).Conclusion: Renal function impairment and electrolyte abnormalities are common in asphyxiatednewborns. The degree of hyponatremia, hyperkalemia, raised serum creatinine and blood urea levelwere directly proportionate to severity of asphyxia. The early identification and time basedintervention to assess renal function and electrolyte abnormality in the early post asphyxiatedperiod will significantly reduce the morbidity and mortality.