The Effect of Neonatal Birth Asphyxia on Renal Function in the First Week of Life: A Prospective Cross-Sectional Study

Abstract

Perinatal asphyxia remains one of the most significant causes of neonatal morbidity and mortality globally, particularly in developing countries. The kidneys are highly susceptible to hypoxic-ischemic injury, making acute kidney injury a common complication in asphyxiated neonates. This study aimed to determine the prevalence and patterns of renal function disturbance in asphyxiated newborns of varying severity during the early neonatal period. This prospective cross-sectional study was conducted at two tertiary care facilities over a one-year period in 2021. Ninety-eight neonates with perinatal asphyxia admitted to the neonatal intensive care unit were enrolled. Renal function was assessed through serum creatinine, blood urea, electrolytes, and urine output monitoring. Hypoxic-ischemic encephalopathy staging was performed using the Sarnat criteria. Among the 98 neonates, 52% were male, 78.6% were term infants, and 76.5% had normal birth weight. Renal dysfunction occurred in 34.7% of cases. HIE stages I, II, and III accounted for 27.6%, 42.9%, and 29.6% of neonates, respectively. Neonates with renal dysfunction had significantly higher serum creatinine (0.92 ± 0.57 vs. 0.58 ± 0.33 mg/dL; p=0.001) and blood urea levels (40.0 ± 30.38 vs. 11.0 ± 4.32 mg/dL; p=0.001). Mechanical ventilation was significantly associated with renal dysfunction (p=0.011). Mortality was 19.4% and was significantly higher among neonates with renal dysfunction (p=0.004). Perinatal asphyxia is a major cause of neonatal acute kidney injury. Early monitoring of renal function parameters is essential for timely intervention and improved outcomes in asphyxiated neonates.