All issues > Volume 37(7); 1994

Original Article

J Korean Pediatr Soc. 1994;37(7):976-985. Published online July 15, 1994.

Effect of Perinatal Asphyxia and Gentamicin on Urinary β2-microglobulin Concentration and Renal Function in Fullterm Neonates

Hoo Jae HJ Hann¹, Seung Joo SJ Lee¹

¹Department of Pediatrics, College of Medicine, Ewha Wamans University, Seoul, Korea

Abstract

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.

Keywords :Perinatal asphyxia, Gentamicin, Urinary β2-microglobulin