Azotemia in neonates with hyperbilirubinemia

Increased level of indirect bilirubin causes neurologic symptoms. Some of these symptoms may be subclinical starting with decreased feeding and dehydration. The aim of the present study was to evaluate the prevalence of prerenal azotemia in neonates with jaundice and determine its relationship with other variables. Materials and Methods: In a cross-sectional study, 199 neonates admitted with hyperbilirubinemia were included. They had no other complaints. Data about gestational age, age at the onset of jaundice and age of admission were recorded. At the time of admission, blood samples for measurement of BUN, Cr, and bilirubin level were collected. Neonates with prerenal azotemia were detected. Correlation between azotemia, level of bilirubin and other variables was evaluated. Results: Mean gestational age of the neonates in the present study was 38.2 ± 1.8 weeks. 58.7% of them were male and 10.9% were premature. Mean age at the onset of jaundice and age at the time of admission were 4.2 ± 2.9 and 6.1 ± 3.5 days, respectively. Mean bilirubin level at the time of admission was 17.5 ± 3.1 mg/dl. Based on BUN level at the time of admission, 10.7% of the neonates had prerenal azotemia. There was a significant correlation between age at the onset of jaundice and age of admission, bilirubin level and BUN level and prevalence of azotemia. Conclusion: Neonates with hyperbilirubinemia may have subclinical symptoms and low appetite causing dehydration. We suggest evaluating the neonates with high bilirubin level for hydration status and possibility of prerenal azotemia especially in younger neonates.