Abstract
Introduction: Birth asphyxia is an eventuality having far reaching consequences in the neonatal period. Hypoxia and ischemia can cause damage to almost every tissue and organ in the body and various target organs involved. Renal insult is a recognized complication of birth asphyxia and carries a poor prognosis. Timely detection of renal dysfunction and appropriate management may favorably alter the prognosis in many neonates with birth asphyxia.
 Objective: The present study was done to find out the incidence of acute renal failure in the full term neonates with birth asphyxia.
 Methodology: A cross sectional study was conducted at Birat Medical College Teaching Hospital, Morang, Nepal from 1st September 2017 to 28th February 2018. Fifty full term neonates born with Apgar score of <6 at 5 minutes and fulfilling inclusion criteria were enrolled in the study. Asphyxiated neonates having Serum creatinine >1.5gm/dl or urine output<1ml/kg/hr were labeled as cases of Acute Renal Failure. Blood sample for serum creatinine was collected at 24hrs, 48 hrs and 72 hrs of life.
 Results A total of 50 term asphyxiated neonates were enrolled in the present study. Among them 54% and 46% were males and females respectively with male to female ratio of 1.2:1. In the present study 62% of cases developed acute renal failure in either of the first three days of life with mean urine output 1.02±0.27ml/kg/hr and mean serum creatinine of 1.49±0.32 mg/dL. The incidence of oliguric renal failure was 52% and non oliguric renal failure was 48%.The association between serum creatinine and urine output was statistically significant.
 Conclusion: In the present study birth asphyxia has been an important cause of neonatal acute renal injury, revealing 31 (62%) cases. Monitoring urine output and serum creatinine has helped in detecting the asphyxiated neonates with acute renal injury in the early stage.
Highlights
A total of 50 term asphyxiated neonates were enrolled in the present study
In the present study birth asphyxia has been an important cause of neonatal acute renal injury, revealing 31 (62%) cases
Birth asphyxia is an insult to the fetus or newborn due to lack of oxygen and/or lack of perfusion to various organs.[1]
Summary
Birth asphyxia is an insult to the fetus or newborn due to lack of oxygen (hypoxia) and/or lack of perfusion (ischemia) to various organs.[1] It is one of the major cause of neonatal death in developing countries like Nepal, India and other South East Asian countries as health services are not much more advance. The incidence of perinatal asphyxia is about 1-1.57% in the most centers in developed countries and is usually related to gesta onal age, birth weight and maternal condi ons account for almost 20% of perinatal mortality. Incidence of birth asphyxia is higher in developing countries and it is mainly due to poor health facili es, illiteracy and ignorance.[2]. Rate of birth asphyxia are several folds higher, ranging from 4.6 per 1000 in Cape Town to 26 per 1000 in Nigeria. Rate of birth asphyxia are several folds higher, ranging from 4.6 per 1000 in Cape Town to 26 per 1000 in Nigeria. 3 Incidence of birth asphyxia was 76 per thousand of live births in a study conducted in India.[3]
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