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dysfunction including renal involvement. There is no consensus
on the determination of acute kidney injury (AKI) in neonates
making establishment of the diagnosis and its management
becomes difficult. The Acute Kidney Injury Network (AKIN)
recommends AKI criteria based on increased serum creatinine
level and reduced urine output.
Objectives To identify the prevalence of AKI in asphyxiated
neonates using the AKIN criteria, to compare the difference of
AKI stages, and the glomerular filtration rates (GFR) between
moderate and severe asphyxia.
Methods This was a cross-sectional analytical study conducted
between July 2012 and January 2013. Subjects were all asphyxiated
neonates (Apgar score < 7 at fifth minute) with gestational age of
>35 weeks delivered and hospitalized in Cipto Mangunkusumo
Hospital and Koja District Hospital, Jakarta, Indonesia.
Glomerular filtration rate was calculated using the components
of urine creatinine, serum creatinine, and urine output; while
AKI stages were determined according to AKIN criteria. Urinary
output was measured via urethral catheterization.
Results Of 94 subjects, there were 70 neonates with moderate
and 24 neonates with severe asphyxia, with the prevalence of AKI
was 63%. Twenty one out of 24 neonates with severe asphyxia
experienced AKI, while neonates with moderate asphyxia who
experienced AKI was 38 out of 70 subjects (54%). Two third of
neonates with severe asphyxia who experienced AKI had stage
3 of AKI. More severe AKI stages and lower median GFR were
found in neonates with severe compared to moderate asphyxia
Conclusion The prevalence of AKI in neonatal asphyxia is high
(63%). The more severe degree of neonatal asphyxia, the more
severe AKI stage and the lower median GFR.
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