ASPHYXIA IS ASSOCIATED WITH INCREASED OF ACUTE KIDNEY INJURIES IN FULLTERM NEONATES
Darma Yuda,Gusti Ayu Putu Nilawati,I Wayan Darma Artana
Departement of Child Health Medical Faculty Udayana University Sanglah Hospital Denpasar Bali
Background : Neonatal asphyxia remains a problem due to significantly increased morbidity and mortality. Asphyxia can cause decrease renal perfusion that trigger vasomotor nephropathy and ultimately lead acute kidney injuries (AKI). The aim of this study is to determine association of asphyxia and increase of AKI in full term neonate.
Material : This research was conducted at Sanglah Hospital in Denpasar, from June 2015 until December 2016, in a prospective cohort study until the subject was 4 days old. Incident of AKI was observed since the subject was included by measuring urine output and serum creatinine at age 2 and 4 days. Bivariate analysis of asphyxia with AKI events was made using Chi-square test, the magnitude of the risk of AKI was shown in relative risk (RR). Multivariate analysis between asphyxia, sepsis, heart failure, and amikacin was done using logistic regression. Significant if p <0.05.
Results : Total of 88 subjects was included, consist of 45 subject with asphyxia and 43 subject with vigorous baby. Acute kidney injuries incidence was 54% in asphyxia groups and 7% in vigorous baby groups. Asphyxia significantly associated with the incidence of AKI with p <0.001 and RR 7.64 (Confidence Interval (CI) 95%: 2.48 to 23.55). In a logistic regression analysis obtained asphyxia and sepsis associated with the incidence of ARI in fullterm neonate, p = 0.001, Odds Ratio (RO) to 10.01 (95% CI: 2.61 to 39.01) and p = 0.046 RO 8.91 (CI 95%: 1.04 to 76.38).
Conclusions : The incident of AKI was 54% in fullterm neonates with asphyxia. Asphyxia significantly associated with AKI in fullterm neonates with 7.64 times risk.
Keywords: acute kidney injuries neonatal term asphyxia
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