J Korean Soc Pediatr Nephrol > Volume 11(1); 2007 > Article
J Korean Soc Pediatr Nephrol 2007;11(1): 32-40. doi: https://doi.org/10.3339/jkspn.2007.11.1.32
신생아 질식 환아에서 저산소성 허혈 뇌증의 정도와 급성신부전 발생과의 연관성
박성신, 정성훈, 송준혁, 김선경, 조병수, 김성도
1경희대학교 의과대학 소아과학교실
2경희대학교 의과대학 소아과학교실
3경희대학교 의과대학 소아과학교실
4경희대학교 의과대학 소아과학교실
5경희대학교 의과대학 소아과학교실
6경희대학교 의과대학 소아과학교실
The Correlation between the Severity of Hypoxic Ischemic Encephalopathy and the Development of Acute Renal Failure in Asphyxiated Neonates
Sung-Shin Park, Sung-Hoon Chung, Jun-Hyuk Song, Sun-Kyoung Kim, Byoung-Soo Cho, Sung-Do Kim
1Department of Pediatrics, Kyung-Hee University Hospital
2Department of Pediatrics, Kyung-Hee University Hospital
3Department of Pediatrics, Kyung-Hee University Hospital
4Department of Pediatrics, Kyung-Hee University Hospital
5Department of Pediatrics, Kyung-Hee University Hospital
6Department of Pediatrics, Kyung-Hee University Hospital
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ABSTRACT
Purpose : We performed this study to determine the incidence of acute renal failure(ARF) in birth asphyxia and to correlate the severity of asphyxia and hypoxic-ischemic encephalopathy (HIE) and ARF in asphyxiated neonates.
Methods : Data was retrospectively collected from the medical records of 33 patients with neonatal asphyxia and of 33 neonates with no asphyxia. On the basis the 5-minute Apgar score, the asphyxiated neonates were further grouped into mild(6 or 7), moderate(4 or 5), and severe asphyxia(3 or less). Asphyxiated neonates with HIE were staged by the Sarnat and Sarnat scoring system. We compared serum creatinine, blood urea nitrogen, electrolytes, and urine output on day 3 of life and the incidence and severity of intraventricular hemorrhage(IVH) between each group.
Results : ARF occurred in 8(24.2%) asphyxiated neonates. Of these, 3(37.5%) were oliguric, while 1(10.0%) patient with mild asphyxia, 2(18.2%) of moderate asphyxia, and 5(41.7%) with of severe asphyxia had ARF(P>0.05). One(25%) patient with stage I HIE, 4(50%) with stage II HIE, and 3(75%) of HIE with stage III HIE developed ARF(P<0.01). There was no statistical correlation between the severity of asphyxia and HIE stage. One(7.7%) patient with grade 1 IVE, 0(0.0%) with grade 2 IVH, 2(66.7%) with grade 3 IVH, and 2(100.0%) with grade 4 IVH had ARF(P<0.01). Mortality was higher in asphyxiated neonates with ARF(P<0.05). There was no significant difference between the oliguric and non-oliguric renal failure.
Conclusion : We found that the greater the degree of HIE, the higher was the incidence of ARF. Asphyxiated neonates with ARF had a poorer prognosis.
Key words: Asphyxia | Acute renal failure | Hypoxic ischemic encephalopathy
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