Professor, Dept. of pediatrics,GMC, Kota.

A prospective case control study was conducted in the NICU of a tertiary level referral teaching hospital Dept. Of Pediatrics, J. K. Lone Mother and Child Hospital, Kota to determine the Incidence of Acute Kidney Injury in asphyxiated neonates and to correlate severity of Kidney Injury with hypoxic ischemic encephalopathy (HIE) grading. 110 neonates were enrolled–60 asphyxiated babies and 50 healthy controls. Both the groups were statistically similar in gender distribution (p=0.93), birth weight (p=0.85), age and length distribution (p=0.286). Renal functions were assessed using urinary output, biochemical parameters(B. Urea , S. Creatinine) and sonographic findings. Babies having Kidney Injury were managed on a protocolised plan. Blood urea (28.65±12.12 vs20.78±9.91) and serum creatinine (1.15±0.35 vs0.72±0.21) were significantly higher (p<0.001) in asphyxiated babies compared to the control group. Biochemical derangements correlated well with HIE staging. There was no significant difference in urine output in the control and the study group as significant oliguria was seen in only 11 of the 60 asphyxiated babies and the output did not correlate with severity of asphyxia. Of the 60 asphyxiated -babies 37 (61.66%) had renal failure where as in control only 1 out of 50(2% ) had renal failure i.e. significantly more in asphyxiated babies (X²=40.342; p<0.001. Renal failure was of the non-oliguric type in (26/37) 70.27% cases and oliguric type in (11/37) 29.72% cases. Mortality was higher in babies with oliguric renal failure. We conclude that AKI is a significant problem in asphyxiated neonates with majority of babies having non-oliguric failure. Severity of renal function abnormality correlates well with degree of asphyxia and HIE Staging.