| Effect of Perinatal Asphyxia and Gentamicin on Urinary β2-microglobulin Concentration and Renal Function in Fullterm Neonates |
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Hoo Jae Hann, Seung Joo Lee |
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Department of Pediatrics, College of Medicine, Ewha Wamans University, Seoul, Korea |
| 주산기 가사와 Gentamicin 투여가 뇨 β2-Microglobulin과 신기능에 미치는 영향 |
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한후재, 이승주 |
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이화여자대학교 의과대학 소아과학교실 |
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| Abstract |
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Perinatal asphyxia can cause ischemic injury to immature kidney of neonates. Proximal renal tubule is the most sensitive area, showing various manifestations ranging from mild reversible injury to irreversible tubular necrosis. Aminoglycosides can be nephrotoxic in therapeutic range in immature or damaged kidney. These are the very important factors to be taken into corsideration on fluid therapy and nephrotoxic drugs in neonates. The purpose of this study is to detect renal dysfunction resulting from asphyxia and gentamicin treatment.
The results were as follows:
1) Urinary β2-microglobulin concentration was significantly higher in neonatal asphyxia group irrespective of meconium stain(p<0.05). The group with neonatal asphyxia only(Ia) showed a gradual decline in urinary β2-microglobulin concentration and no significant difference shown when compared with control group on 7 days old(p>0.05). The group with neonatal asphyxia and meconium stain(Ib) received gentamicin for 7 days. Their urinary β2-microglobulin concentration dropped on 4 the day and increased again on 7th day(p<0.05). The group with meconium stain only(III) showed no significant difference in urinary β2-microglobulin concentration when compared with control group(p>0.05).
2) No differences were shown in serum creatinine, serum sodium level and urinary creatinine concentrations between each group(p>0.05).
3) No differences were shown in creatinine clearance between each group(p>0.05). Fractional excretion of urinary sodium(FENa)was significantly higher on 1st day in group I, but no differences were shown afterwards(p>0.05).
4) There is no relationship between urinary β2-microglobulin concentration and serum creatinine level, creatinine clearance or FENa.
5) No differences were shown in incidence of renal dysfunction between each group.
In conclusion, acute tubular injury by perinatal asphyxia recovered soon after birth. But nephrotoxic gentamicin worsened the recovering tubular injury. In case of mild fetal hypoxia without neonatal asphyxia, proximal tubular injury was not significant. |
| Key Words:
Perinatal asphyxia, Gentamicin, Urinary β2-microglobulin |
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