Medani Safaa A, Kheir Abdelmoneim E M, Mohamed Mazahir B
(1) Department of Paediatrics, Faculty of Medicine, Neelain University, Khartoum, Sudan.
(2) Department of Paediatrics, Faculty of Medicine, University of Khartoum, Sudan.
Sudan J Paediatr. 2014;14(2):29-34.
Acute kidney injury (AKI) is a recognized complication of birth asphyxia. Early recognition of AKI is important in asphyxiated neonates as it helps in early intervention and appropriate management. The aim of this study was to determine the pattern of AKI in asphyxiated neonates and its relation to the grade of Hypoxic Ischemic Encephalopathy (HIE). This was a prospective hospital based study, conducted in the neonatal intensive care unit (NICU) at Gafaar Ibn Auf Children's Specialized Hospital during the period between January 2013 and December 2013. A total of 85 full term asphyxiated neonates who were admitted in NICU and diagnosed as HIE were enrolled in this study. with 50 (58.8%) less than 7 days of age, 31(36.5%) between (8-15) days and 4(4.7%) between (16-28) days. Males were found to be more affected than females (58.9% and 41.1%) respectively. Spontaneous vaginal delivery was the mode of delivery in 48(56.4%), assisted vaginal delivery in 14(16.5%), emergency caesarian in 19(22.4%) and elective caesarian section in. Percentage of AKI in those babies was 54.1%(46). With 30(65%) from those had non-oliguric type. Ten babies (21.7%) had serum creatinine between (1.5 - 2mg/dl), 29 (63.04%) between (2 - 3mg/dl) and 7(15.22%) between (3-4mg/ dl). This means that the majority of patients presented in injury stage. Hyperkalemia was found in (37.6%), hyponatremia in (27.1%) and hypocalceamia in (25.8%). Most of the babies with AKI had stage (ii) HIE. All babies were treated conservatively and 4(8.6%) died. In conclusion AKI was observed to be a common complication in asphyxiated neonates.
急性肾损伤（AKI）是出生窒息公认的并发症。对于窒息新生儿，早期识别AKI很重要，因为这有助于早期干预和恰当管理。本研究的目的是确定窒息新生儿中AKI的模式及其与缺氧缺血性脑病（HIE）分级的关系。这是一项基于医院的前瞻性研究，于2013年1月至2013年12月期间在加法尔·伊本·奥夫儿童医院新生儿重症监护病房（NICU）进行。共有85例入住NICU且被诊断为HIE的足月儿窒息新生儿纳入本研究。其中50例（58.8%）年龄小于7天，31例（36.5%）年龄在（8 - 15）天之间，4例（4.7%）年龄在（16 - 28）天之间。发现男性受影响比女性更严重，分别为58.9%和41.1%。48例（56.4%）为自然阴道分娩，14例（16.5%）为助产阴道分娩，19例（22.4%）为急诊剖宫产，[此处原文未给出择期剖宫产的比例数据]。这些婴儿中AKI的比例为54.1%（46例）。其中30例（65%）为非少尿型。10例婴儿（21.7%）血清肌酐在（1.5 - 2mg/dl）之间，29例（63.04%）在（2 - 3mg/dl）之间，7例（[此处原文可能有误，推测应为15.22%]）在（3 - 4mg/dl）之间。这意味着大多数患者处于损伤期。发现高钾血症的比例为（37.6%），低钠血症为（27.1%），低钙血症为（25.8%）。大多数患有AKI的婴儿为（ii）期HIE。所有婴儿均接受保守治疗，4例（8.6%）死亡。总之，AKI是窒息新生儿中常见的并发症。
