Beta-2-microglobulin in the assessment of renal function in full term newborns following perinatal asphyxia

In order to evaluate the clinical usefulness of serum and urinary s2 microglobulin (s2-m) determination as a marker of renal damage following perinatal asphyxia, twenty asphyxiated and twenty healthy full term newborns were studied. Renal function was monitored on the first and third day after birth by traditional tests such as creatinine (Cr), endogenous creatinine clearance (Ccr), and fractional Na excretion (FeNa), as well as by serum and urinary s2 microglobulin. The value of different tests for the diagnosis of oliguria and of acute renal failure was determined. Eleven asphyxiated neonates developed oliguria and five ARF in contrast to none of the controls. Both traditional tests of renal function, and determinations of s2-m with the exception of serum s2-m, were significantly different (p < 0.01) between controls and asphyxiated J. Perinat. Med. 17 (1989) Fernandez et al, s2 microglobulin and renal function after perinatal asphyxia 457 neonates. When stratified analysis was performed, only serum cr, urinary s2-m/cr ratio, and Fes2-m were able to discriminate oliguria from preserved diuresis on the first day of life. For ARF, only Ccr and Fes2-m were different, again on the first day of life. Urinary s2-m/ creatinine ratio and Fes2-m appear to be more sensitive and specific for the early detection of proximal tubular renal dysfunction following perinatal asphyxia than usual tests of renal function.