Renoprotective effects of therapeutic hypothermia in neonates with perinatal asphyxia

Abstract Background To compare renal blood flow and renal function tests in infants with perinatal asphyxia, and the effects of therapeutic hypothermia(TH) during the first seven days of life. Methods Fifty-nine patients with hypoxic ischemic encephalopathy(HIE) were prospectively evaluated. Patients with stage 2-3HIE who required TH were classified as Group1(n=36), patients with Stage 1 HIE who did not need TH were classified as Group2(n=23), and healthy infants were classified as Group3(n=60). Renal function tests were evaluated on the 6th hour, 3rd and 7th days of life in Group1 and Group2, and on the 6th hour and 3rd day of life in Group3. KDIGO Classification was used to diagnose AKI in all patients. Renal artery(RA) Doppler ultrasonography(dUS) was performed in all infants on the 1st, 3rd and 7th days of life. Results Serum cystatinC levels were gradually decreased and glomerular filtration rate(GFR) was gradually increased during TH on Group1. Systolic and end-diastolic blood flow in RA tended to increase and RA resistive index (RI) tended to decrease with time in Group1. While end-diastolic blood flow rates in RA on the 3rd day was similar in patients with stage3 HIE and stage 1 HIE, it was lower in patients with stage 1,2,3 HIE than healthy newborns. On the 7th day, all the three groups had similar values. Stage 3 AKI was not observed in any of the cases. Conclusion Therapeutic hypothermia seems to help to restore the renal blood flow and renal functions during the neonatal adaptive period along with its neuroprotective properties.