Acute kidney injury (AKI) is a common complication of perinatal asphyxia and is associated with poorer short-term and long-term outcomes. This retrospective study describes the incidence of AKI in asphyxiated neonates who have received therapeutic hypothermia using the proposed modified Kidney Diseases: Improving Global Outcomes (KDIGO) definition and investigates clinical markers that would allow earlier recognition of at-risk neonates. We included asphyxiated neonates who underwent therapeutic hypothermia between the period of January 2011 and May 2018 in our study. The serum creatinine levels within a week of birth were used in establishing AKI according to the modified KDIGO definition. Demographic data, resuscitation details, laboratory results and use of medications were collected and compared between the AKI and non-AKI groups to identify variables that differed significantly. A total of 66 neonates were included and 23 out of them (35%) were found to have AKI. The neonates with AKI had a lower gestational age (p = 0.006), lower hemoglobin level (p = 0.012), higher lactate level before and after therapeutic hypothermia (p = 0.013 and 0.03 respectively) and higher troponin-I level after therapeutic hypothermia (p < 0.001). After logistic regression analysis, elevated troponin-I after therapeutic hypothermia was independently associated with risk of AKI (OR 1.69, 95% CI 1.067–2.699, p = 0.025). The receiver operating curve showed that troponin-I after therapeutic hypothermia had an area under curve of 0.858 at the level 0.288 ng/ml. Our study concludes that the incidence of AKI among asphyxiated newborns who received therapeutic hypothermia is 35% and an elevated troponin-I level after therapeutic hypothermia is independently associated with an increased risk of AKI in asphyxiated newborns.

急性肾损伤 (AKI) 是围产期窒息的常见并发症，与较差的短期和长期结局相关。这项回顾性研究描述了使用拟议的改良肾脏疾病：改善全球结局 (KDIGO) 定义接受治疗性低温治疗的窒息新生儿中 AKI 的发生率，并调查了有助于早期识别高危新生儿的临床标志物。我们的研究纳入了在 2011 年 1 月至 2018 年 5 月期间接受治疗性低温治疗的窒息新生儿。根据改良的 KDIGO 定义，出生一周内的血清肌酐水平用于建立 AKI。人口统计数据、复苏详情、收集实验室结果和药物使用情况，并在 AKI 和非 AKI 组之间进行比较，以确定显着不同的变量。总共包括 66 名新生儿，其中 23 名 (35%) 被发现患有 AKI。AKI 新生儿的胎龄较低（p  = 0.006)、较低的血红蛋白水平 ( p  = 0.012)、治疗性低温前后较高的乳酸水平（ 分别为p = 0.013 和 0.03）以及治疗性低温后较高的肌钙蛋白 I 水平（p  < 0.001）。Logistic 回归分析后，低温治疗后肌钙蛋白-I 升高与 AKI 风险独立相关（OR 1.69, 95% CI 1.067–2.699, p = 0.025）。受试者工作曲线显示，治疗性低温后肌钙蛋白-I 在 0.288 ng/ml 水平下的曲线下面积为 0.858。我们的研究得出结论，接受低温治疗的窒息新生儿的 AKI 发生率为 35%，低温治疗后肌钙蛋白-I 水平升高与窒息新生儿 AKI 风险增加独立相关。