ASFIKSIA NEONATORUM SEBAGAI FAKTOR RISIKO TERJADINYA GAGAL GINJAL AKUT

Abstract

Background. Birth asphyxia is one of the most important cause of morbidity and mortality in neonates that leads to organ dysfunction. Around 50% organ dysfunction occurred in kidney that leads to acute renal failure (ARF). Early detection of ARF condition could be used to prevent kidney disturbances. Objective. To determine birth asphyxia as a risk factor for ARF. Methods. A prospective cohort study was conducted in January-December 2010 in Dr Kariadi Hospital with asphyxiated neonates as an inclusion criteria. The expose group were severe asphyxia and moderate asphyxia as a non expose group, both taken with consecutive sampling method. ARF was based on ureum, creatinin serum level and urinary output on day fourth and fifth of admission. Statistical analysis were done using Chi-square, Mann-Whitney, Kolmogorov-Smirnov and non-paired t-test. Results. Subjects were 63 neonates. The incidence of ARF on moderate and severe asphyxiated neonates was 39,7%. All of ARF cases were oliguric type. In ARF case, on day 4th the mean level of serum ureum were 33.6 (±13.53) mg/dL, creatinin 1.54 (±0.35) mg/dL and urinary output 0.45 (±0.07) mL/kgBW/hour compared with day 5th Conclusion. Severe asphyxia was significant risk factor for ARF. , there were increased of ureum 41.36 (± 14) mg/dL and decreased of creatinin 1.39 (±0.3) mg/dL and urinary output 0.45 (±0.06) mL/kgBW/hour with p<0.05. The highest incidence of ARF was found in severe asphyxia 56.3% (p=0.006; RR 2.5; 95%CI 1.2-5.1). Gentamycine with dose 5mg/kgBW/day for five days was not a risk factor for ARF (p=0.052; RR 5.08; 95%CI 0.77-33.66). Keywords : acute renal failure, asphyxia