title: Treating perinatal asphyxia with theophylline at birth helps to reduce the severity of renal dysfunction in term neonates.
abstract: OBJECTIVE
  Perinatal asphyxia is a common neonatal problem and contributes significantly to neonatal morbidity and mortality. This study was designed to determine whether theophylline could prevent or ameliorate renal dysfunction in term neonates with perinatal asphyxia.
  
  
  METHODS
  We randomised 159 severely asphyxiated term newborns to receive a single dose of 5 mg/kg intravenous theophylline (n = 78) or a placebo (n = 81) during the first hour of life. The infant's 24-hour fluid intake, urine volume, serum creatinine, creatinine clearance and sodium excretion were recorded during days one, three and five of life, starting 12 hours after the theophylline or placebo infusion.
  
  
  RESULTS
  Neonates in the theophylline group had lower serum creatinine levels (0.83 ± 0.35 versus 1.47 ± 0.61; p = 0.00) and higher endogenous creatinine clearance (32.16 ± 16.34 versus 17.73 ± 7.92; p = 0.00) than the placebo group. Severe renal dysfunction, namely acute kidney injury, was present in 36 (15%) of the neonates in the theophylline group versus 117 (48%) in the placebo group (p < 0.01).
  
  
  CONCLUSIONS
  A single dose of intravenous theophylline administered to term neonates with perinatal asphyxia within the first hour of life significantly decreased serum creatinine levels and significantly increased creatinine clearance.
authors.affiliation: Department of Pediatrics, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Raina
authors.affiliation: Department of Pediatrics, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India. aakash.pandita@gmail.com.
authors.forename: Aakash
authors.initials: A
authors.lastname: Pandita
authors.affiliation: Department of Pediatrics, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Rekha
authors.initials: R
authors.lastname: Harish
authors.affiliation: Department of Nephrology, SGPGI, Lucknow, India.
authors.forename: Monika
authors.initials: M
authors.lastname: Yachha
authors.affiliation: Department of Pediatrics, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Ashu
authors.initials: A
authors.lastname: Jamwal
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D051437:Renal Insufficiency / Q000209:etiology / Q000517:prevention & control*; D013806:Theophylline / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D013806:Theophylline
keywords: Acute kidney injury; Creatinine clearance; Perinatal asphyxia; Theophylline