Renal Failure in Asphyxiated Term Babies Frequency and Severity Associated with Apgar Scoring and Hie Grading

Abstract

Objective: To determine the frequency and severity of renal failure in asphyxiated neonates and to correlate it with 
Apgar score and Hypoxic ischemic encephalopathy (HIE) grading. 
Study Design: Analytic Study. 
Place and Duration of Study: This study was conducted in Department of Pediatrics, Lahore General Hospital 
(LGH)/Postgraduate Medical Institute (PGMI) Lahore for a period from Feb 2010 to Jan 2011. 
Materials and Methods: All the deliveries taking place in LGH during the working hours of 8 am to 2 pm were 
attended by senior doctors on call and asphyxiated babies (apgar 7 or less at 5 mins) were enrolled for the study. 
After every one week one non asphyxiated baby with no known confounding factor believed to alter renal function 
was randomly picked up to serve as a control. Gestational age, birth weight, relevant perinatal history, findings on 
physical evaluation and systemic sings were entered in a predesigned proforma. Investigations like urine complete, 
renal functions test (RFTs) and serum electrolytes were monitored initially within 24 hours of birth, day 3rd of life 
and repeated when required. Abdominal ultrasound, arterial blood gases (ABGs) and electrocardiography (ECG) 
was done when required. Data were analyzed and relation of frequency and severity of renal failure with apgar 
scoring and HIE was noted. 
Results: Of 150 asphyxiated babies, 60 (40%) had renal failure. 29(19.33%) had proteinuria ++ or more and 
17(11.33%) developed hematuria. Of 40 non-asphyxiated babies no neonate had abnormal renal function. 
Sonography was abnormal in 55 cases, all were those having renal failure. Renal parameters normalized in all 
neonates by two months of age. 11(7.33%) babies expired. All of them were of oliguric renal failure.