PERINATOLOGIYA I PEDIATRIYA.2013.4(56):96–99

Noninvasive diagnostics of renal dysfunction in newborns with asphyxia

Loboda A. N., Markevich V. E.

Medical Institute of Sumy State University, Sumy, Ukraine

Objective. To examine the possibilities of noninvasive diagnosis of renal dysfunction in newborns with asphyxia — definition of the level of interleukin-18 (IL-18) in the urine.

Patients and methods. A total of 100 term newborns with gestational age 38–41 weeks with the signs of renal dysfunction in the setting of asphyxia and 20 newborns without presence of asphyxia. Renal dysfunction diagnosed in condition of increased level of blood creatinine over 89 mmol/L , blood urea over 8 mmol/L, urine output index less than 1 ml/kg/hour. The level of ІL-18 in the morning urine ( 6.00–10.00 ) was determined by 1–2, 7–8 and 25–30^th day of life by enzyme linked immunosorbent assay on «Stat Fax 303 Plus» (USA). Statistical analysis was performed by the use of Statistica 6.1 program (StatSoft, USA). As the present data did not fit a normal distribution, nonparametric statistical methods were used — that is Wilcoxon two-sample test. Spearman's rank correlation coefficient was used for checking of interaction between the variables. The difference was considered significant at p <0.05. Friedman analysis of variance was used for determination of the effect on the index of ІL-18 of such factors as child's age and weight.

Results. It is found, that increased content of IL-18 in urine of newborn at 1–2-days of life may be an early predictor of renal dysfunction. At the same time, the prevalence of serum creatinine can not be regarded as a reliable early marker of kidney disorders. Significant content of cytokine in the urine of children with severe asphyxia is evidence of considerable damage of the proximal renal tubule epithelium.

Conclusions. The level of IL-18 in the urine depends on the severity of asphyxia and age of the child, but is not associated with birth weight and sex of the child.

Key words: asphyxia, kidney, interleukin-18, urine.

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