Spot Urine Uric Acid Level as Early Marker of Kidney Injury in Birth-asphyxiated Newborns
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2019, Vol 6, Issue 11
Abstract
Introduction: Perinatal asphyxia is a condition defined as hypoxemia, hypercapnia, and acidosis in neonate. Cellular hypoxia leads to increased excretion of uric acid. This study was conducted to assess the feasibility of urine uric acid level for the identification of kidney injury in asphyxiated newborns in first 48 h of life. Aims and objectives: The aims and objectives of this study were to evaluate the utility of urinary uric acid levels within 48 h of birth as non-invasive and early biochemical means of identifying kidney injury in birth asphyxiated neonates. Material and methods: Study design - this was a prospective observational cohort study. Settings - this study was conducted at neonatal intensive care unit in tertiary level hospital in Central India. Duration - the study duration was from July 2017 to June 2018. Due to financial constraints, 100 neonates were enrolled and urine sample collected within 48 h of life was evaluated for urine uric acid level. On day 3rd of life, serum creatinine was done. Statistical analysis was performed by Mann–Whitney U-test. Results: The mean rank of urine uric acid (32.76 vs. 20.29) was significantly higher in term newborns as per asphyxia (P = 0.005). The mean rank of urine uric acid (24.13 vs. 15.46) was significantly higher in term asphyxiated as per urine output (P = 0.031). However, the mean rank of urine uric acid (23.29 vs. 16.00) was not significant in term asphyxiated newborns as per serum creatinine (P = 0.08). Conclusions: Urine uric acid = 16.10 μmole/24 h has a sensitivity (61.4%) and specificity (72.2%) for detecting asphyxia in newborns. Similarly, urine uric acid = 22.3 μmole/24 h has a sensitivity (66.7%) and specificity (91.4%) for detecting kidney injury in asphyxiated newborns.
Authors and Affiliations
Darshan Kataria, Karan Joshi, Jyoti Singh
Keywords
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