الفهرس 
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Abstract
Newborn infants with perinatal asphyxia are prone to the development of hypoxic-ischemic encephalopathy. Perinatal asphyxia is still one of the most important factors contributing to neonatal morbidity and mortality. Asphyxiated infants are at risk of multiorgan dysfunction (MOD) which is one of consensus based criteria for the diagnosis of intrapartum asphyxia. MOD was present in all infants with severe post-asphyxia hypoxic-ischemic encephalopathy (HIE) (at least one organ dysfunction in addition to HIE) as renal, cardiovascular, pulmonary, and hepatic dysfunction.Renal involvement occurred in 42% of theses infants. Perinatal asphyxia causes renal damage whether directly via hypoxia and/or indirectly via decreased renal blood flow. The asphyxiated infant is at risk of acute tubular necrosis, syndrome of inappropriate secretion of ADH and acute renal failure. The proximal convoluted tubules are particularly susceptible to hypoxia. Early recognition of acute renal failure is important in asphyxiated infants with hypoxic ischemic encephalopathy. The present work aims to evaluate the incidence of renal affection in newborn with perinatal asphyxia. This case control study was conducted from May 2012 to April 2013 in neonatal intensive care units of Banha children hospital and involved 80 neonates; 40 asphyxiated neonates as patient group and 40 normal neonate as control group All patients were subjected to full history taking and complete clinical examination and laboratory investigation include: routine investigations CBC, CRP, Arterial blood gases ,daily assessment of urine output, specific investigations (done on 3rd day of life) serum electrolytes including serum Na, K, blood urea and serum creatinine, urine sodium and creatinine, calculation of fractional excretion of sodium and renal failure index and radiological studies as cranial U/S, CT brain and abdominal ultrasound when needed .Data were tabulated and processed by usual statistical program. In this case control study the patients and controls were matched for gender, birth weight, and age distribution and were statistically similar. Among the patient group 42.5% had meconium stained amniotic fluid, 10% had prolonged second stage of labor, 12.5% obstructed labor, 12.5% Antepartum hemorrhage and 15%had pre-eclampsia as perinatal risk factors. The incidence of acute renal failure in the patient group was 47.5 %.(19 patients),among these patients with acute renal failure 21.1 %(4 patients)were oliguric RF and 78.9% (15 patients)were non oliguric RF and 84.2 %(16 patients) had pre-renal failure and (3 patients) 15.8% had intrinsic renal failure. Renal failure index and fractional excretion of sodium were done to differentiate pre-renal failure and intrinsic renal failure. Incidence of acute renal failure increased as the HIE staging progressed, as from the 40 patients of the patient group: 7 patients had HIE grade Ι and all had no ARF , 25 patients had HIE grade ΙΙ ; 12 patients of them had ARF and all were of pre-renal failure type and 8 patients had HIE grade ΙΙΙ; 7 patients of them had ARF( 4 patients had pre-renal failure and 3 patients had intrinsic RF).