THE POSSIBLE ROLE OF URIC-ACID IN RENAL HYPER-ECHOGENICITY IN NEONATAL HYPOXIC ACUTE SHOCK

Sonographic examinations as well as blood and urine chemistry tests we re carried out in 4 neonates (3 mature, 1 premature) with transient re nal failure, who were suffering from the effects of neonatal asphyxia of varying etiology. The first ultrasound examinations of the kidneys were performed within 24 hours after the hypoxic event. Simultaneously , blood and urine tests for parameters of renal function and purine me tabolites were also carried out. Transient insufficiency of renal func tion could be detected in all cases with hyper-uricemia and hyper-uric osuria with no hypercalciuria. Ultrasonographic examinations showed hy per-echogenicity of the renal pyramids in all of the cases and hyper-r eflectivity of the renal cortex in cases 2 and 4. In 3 cases, hyperech ogenicity appeared within 24 hours and disappeared in a short time, wh ile in case 3 it could be detected from day 4 until day 14. These find ings demonstrate, that the neonatal kidney is very sensitive to hypoxi a and that hypoxic renal failure is accompanied by hyper-echogenicity of the kidneys. Uric acid is a possible cause of the renal hyper-echog enicity.