Study comparing the efficacy of Caffeine vs. Theophylline in Asphyxiated newborn for prevention of AKI

Abstract

Background: Perinatal asphyxia is a multisystem disorder involving many organs, but its effect is more significant in the heart, brain, and kidneys. Involvement of kidneys presents as oliguria and sometimes anuria in the newborn. We compared the efficacy of prophylactic caffeine vs. theophylline given in these newborns in preventing AKI. Materials and Methods: We performed a prospective study on the asphyxiated term and late preterm newborn babies admitted to the NICU. We allotted babies into group C and T, two groups – Group C –was given Caffeine, and Group T – theophylline. Theophylline and Caffeine drugs were given prophylactically as a single dose intravenously within 12 hours of birth. Babies were monitored for the development of renal injury, both clinically and with laboratory values. Serum creatinine and cystatin C levels in both groups were compared. Results: A total of 100 babies with clinically confirmed perinatal asphyxia were allotted to 2 groups, 50 babies each. In the theophylline group, there were two deaths (4%), and in the caffeine group, only one death (2%) (P = 0.634). Clinically and laboratory wise both groups did not have any acute kidney injury. The cystatin C levels on day 1 were higher in Theophylline group than Group C (Caffeine) in our study. Further, these levels were higher than those in the study by M.Treiber et al. (P = 0.005). Conclusion: Caffeine group babies had a better outcome, as the caffeine group had lower cystatin C levels on day three than theophylline group. Hence, caffeine is as effective as theophylline in the prevention of AKI in asphyxiated newborns. Keywords: Perinatal asphyxia, Caffeine, Theophylline, Cystatin C.