Abstract
The kidney is the most damaged organ in asphyxiated full-term infants. The severity of its damage is correlated with the severity of neurological damage. We determined the prevalence of perinatal asphyxia-associated acute kidney injury (AKI). We conducted a prospective cohort study including 60 full-term neonates admitted at the Kenyatta National Hospital newborn unit (NBU) in Nairobi with hypoxic ischaemic encephalopathy (HIE) from June 2012 to November 2012. Renal function was assessed by measuring serum creatinine on day 3 of life. AKI was defined by a level of creatinine above 133 µmol/l. The degree of neurological impairment was determined daily until patient discharge, death or day 7 of life. Of the 60 infants 36.6% had HIE I, 51.6% HIE II and 11.8% HIE III. The prevalence of AKI was 11.7 %. There was a 15 fold increase risk of developing AKI in HIE III versus HIE I, p=0.034. Mortality rate in perinatal asphyxia associated AKI was 71.4 % with a 24 fold increase risk of death in neonates with AKI, p=0.001. AKI is common and associated with poorer outcomes in perinatal asphyxia. Larger studies need to be done to correlate maternal factors and perinatal asphyxia-associated AKI.
Highlights
Perinatal asphyxia is defined by the World Health Organisation (WHO) as “Failure to initiate and sustain breathing at birth.”(1) There is a high incidence of acute kidney injury (AKI) among the asphyxiated term infants, (50 – 72%). [2,3]
We conducted a prospective cohort study including 60 full-term neonates admitted at the Kenyatta National Hospital newborn unit (NBU) in Nairobi with hypoxic ischaemic encephalopathy (HIE) from June 2012 to November 2012
Perinatal asphyxia is defined by the World Health Organisation (WHO) as “Failure to initiate and sustain breathing at birth.”(1) There is a high incidence of AKI among the asphyxiated term infants, (50 – 72%). [2,3]
Summary
Perinatal asphyxia is defined by the World Health Organisation (WHO) as “Failure to initiate and sustain breathing at birth.”(1) There is a high incidence of AKI among the asphyxiated term infants, (50 – 72%). [2,3]. The presence of perinatal asphyxia and its severity appear to correlate with increasing incidence of AKI. [2,4] Asphyxia is an important cause of AKI and transient kidney impairment with adverse effects, especially in the five days of birth.[5,6] The kidney is the most damaged organ in asphyxiated full- term infants. Most of the previous investigators have defined AKI in neonates as serum creatinine above 133 μmol/(l. The objective of this study was to determine the prevalence of acute kidney injury using serum creatinine above 133 μmol/l and short term outcomes of moderate to severe perinatal asphyxia-associated acute kidney injury. We determined the prevalence of perinatal asphyxia-associated acute kidney injury (AKI).
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