| A Prospective Study ot Neonatal Acute Renal Failure: The Significance of Various Diagnostic Indices. |
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Kyung Hyo Kim, Seung Joo Lee, Keun Lee |
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Department of Pediatrics, College of Medicine, Ewha Womans University |
| 신생아기의 급성 신부전과 각종 진단 기준의 평가 |
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김경호, 이승주, 이 근 |
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이화여자대학교 의과대학 소아과학교실 |
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| Abstract |
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Acute renal failure is defined as a sudden decrease in renal function resulting in progressive
retention of nitrogenous waste products. Acute renal failure should be suspected in any infant who has
a sustained decrease in urine output to less than 1 ml per kg per hour, a blood urea nitrogen level
above 20 mg per dl, a serum creatinine level greater than 1.0 mg per dl or who fails to void within
48 hours of birth.
Reduced renal perfusion in asphyxiated infant may result from several factors including hypoxia,
hypotension, and acidosis. Prerenal acute renal failure is rapidly reversible early in the course of
disease, if renal perfusion will ensue.
Between December 1, 1984 and September 30, 1985, 78 inborn asphyxiated full term neonates were
screened for evidence of oliguria and including 18 outbom oliguric neonates, we studied for the
incidence of acute renal failure and diagnostic criteria that would separate prerenal from intrinsic
renal failure.
The results were as follows:
1) A diagnosis of presumptive acute renal failure was entertained in 18 of 78 (22.9%) inborn,
asphyxiated neonates, but only 1 of 18 (5.6%) failed to respond to a rapid intravenous fluid challenge
and was classified as having intrinsic renal failure. In 18 outbom oliguric neonates, 5 (27.9%) were
classified as having intrinsic renal failure (p<0.05).
2) We evaluated diagnostic criteria that would separate prerenal from intrinsic renal failure and
sharp demarcation of the two groups were possible only when the urine to serum ratios of creatinine,
renal failure index or fractional excretion of sodium was used.
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| Key Words:
Neonate, Asphyxia, Acute renal failure, Diagnostic indices
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