Background: Acute Kidney Injury (AKI) is a recognized complication of birth asphyxia and may result in renal damage. Early recognition of AKI is important.

Objective and Design: In this case control study, we determined the incidence of AKI in birth asphyxia and correlated the severity of acute kidney injury with HIE staging. Duration from February 2013 to August 2014.

Setting: Tertiary care neonatal unit in eastern India.

Material and Methods: 100 term (37–42wks) neonates  with Apgar score of 7/<7 at 1 minutes  were selected as cases and 50 normal term  (37–42 wks) neonates were as controls. All asphyxiated neonates ( WHO definition) were  staged by Sarnat and Sarnat staging. Between 72 hrs to 96 hrs of life blood was collected for relevant investigations.

Results: Incidence of AKI was more in cases (75.0% vs 4.0%) . Among  75 cases of AKI 64  had pre–renal and 11 had intrinsic AKI and based on urine output 24 had oliguric  and 51 had non–oliguric AKI, among  50 controls 2 neonates had pre–renal and non–oliguric type of AKI. Among  75 cases 64 improved  after fluid therapy and 11 did not . 9 neonates died, among them 7 had associated morbidities and refused Peritoneal Dialysis(PD), 2 underwent PD and died and 2 went LAMA(Leave Against Medical Advice).Among 9 neonates who died 4 had oliguric  and 5  had non oliguric AKI.

Conclusion: AKI in birth asphyxia is predominantly pre–renal and non oliguric type and correlates well with HIE staging.