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Article Type

Original Study

Abstract

Objective: To assess the renal failure index (RFI) in asphyxiated neonates in relation to other clinical and laboratory findings among those with acute renal failure, whether prerenal or intrinsic renal failure. Background: Asphyxia is an important cause of morbidity and mortality among neonates. It leads to multiorgan dysfunction and redistribution of cardiac output to maintain cerebral, cardiac and adrenal perfusion while potentially compromising renal, gastrointestinal and skin perfusion. Thus, acute renal failure is recognized as a complication of birth asphyxia. Materials and Methods: This case–control study included 80 neonates divided into two groups: the patient group (40 babies with perinatal asphyxia) and the control group (40 normal babies). In all patients, hypoxic ischemic encephalopathy staging (Sarnat and Sarnat) was performed. Blood and urinary parameters for renal function were assessed in all newborns, and fractional excretion of sodium (FENa) and the RFI were also calculated. The results obtained were analyzed and compared within subgroups using the computer program statistical package for social science, version 16. Results: Acute renal failure was noted in 19 patients in the patient group (47.5%): 16 of them (40%) had prerenal failure and three had intrinsic renal failure (7.5%). FENa and the RFI were found to be the most useful in evaluating babies with renal failure, as these derived renal indices were more reliable than individual parameters. FENa and RFI increased with increasing hypoxic ischemic encephalopathy staging. Conclusion: Perinatal asphyxia is an important cause of neonatal acute renal failure, which is predominantly prerenal failure. FENa and RFI are useful parameters for assessing the renal function in these neonates and can be used to differentiate prerenal failure from intrinsic renal failure, and thus helps in proper management.

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