{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:42:31Z","timestamp":1792701751453,"version":"4.5.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Hypothermia and Temperature Management"],"published-print":{"date-parts":[[2026,12,1]]},"abstract":"<jats:p>\n                    Hypoxic\u2013ischemic encephalopathy (HIE) is a critical neonatal condition for which therapeutic hypothermia (TH) remains the cornerstone of neuroprotective intervention. Clinical observations and prior studies note that electrolyte imbalances\u2014particularly hyponatremia and hypokalemia\u2014frequently emerge during TH. Therefore, this study explores how activation of the renin\u2013angiotensin\u2013aldosterone system (RAAS) may contribute to sodium (Na) and potassium (K) disturbances in asphyxiated neonates receiving TH. In this prospective study, 38 newborns with HIE treated with TH and 21 healthy term newborns were enrolled. Serum renin, aldosterone, Na, K, and urinary electrolyte levels were measured at 24, 48, and 72 hours postnatally. Receiver operating characteristic analyses assessed the diagnostic performance of renin and aldosterone. Renin and aldosterone levels were significantly elevated in the TH group compared with controls (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.05). Serum sodium levels were consistently lower at all time points (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.001), while potassium levels were significantly reduced at 24 and 72 hours (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.05). Fractional excretion of sodium was increased at 24 hours, and potassium excretion remained elevated throughout the TH period (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.05). Among the biomarkers, aldosterone demonstrated excellent diagnostic performance at 24 hours (AUC = 0.919). Activation of the RAAS is evident in asphyxiated neonates undergoing TH, with aldosterone playing a pivotal role in electrolyte disturbances. These results highlight the clinical importance of vigilant monitoring and timely correction of serum sodium and potassium levels during the hypothermia protocol.\n                  <\/jats:p>","DOI":"10.1177\/21537658261416472","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T07:28:16Z","timestamp":1768634896000},"page":"176-182","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Renin\u2013Aldosterone Activation and Enhanced Urinary Potassium Excretion in Asphyxiated Newborns Treated with Therapeutic Hypothermia: A Prospective Study"],"prefix":"10.1177","volume":"16","author":[{"given":"Osman","family":"Ba\u015ftu\u011f","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit, Kayseri City Hospital, Health Sciences University, Kayseri, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahad\u0131r","family":"\u0130nan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kayseri City Hospital, Health Sciences University, Kayseri, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Kayseri City Hospital, Health Sciences University, Kayseri, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Funda","family":"Ba\u015ftu\u011f","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Kayseri City Hospital, Health Sciences University, Kayseri, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7i\u011fdem","family":"Karak\u00fckc\u00fc","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Kayseri City Hospital, Health Sciences University, Kayseri, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmi017"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12403"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-010-0034-0"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198704000-00006"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2016.11.001"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2004.06.014"},{"key":"e_1_3_3_8_1","volume-title":"StatPearls","author":"Gillam-Krakauer M","year":"2025","unstructured":"Gillam-Krakauer M, , Shah M, , Gowen CW.Jr., Birth Asphyxia. 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The effect of the implementation of therapeutic hypothermia on fluid balance and incidence of hyponatremia in neonates with moderate or severe hypoxic-ischaemic encephalopathy. Acta Paediatr, 2013; 102(11):e507\u2013e513.","journal-title":"Acta Paediatr"},{"key":"e_1_3_3_16_1","volume-title":"StatPearls","author":"Rogoff B","year":"2022","unstructured":"Rogoff B, , Pride YB. EKG Rhythm. In: StatPearls. StatPearls Publishing: Treasure Island, FL; 2022."},{"key":"e_1_3_3_17_1","volume-title":"StatPearls","author":"Scott JH","year":"2023","unstructured":"Scott JH, , Menouar MA, , Dunn RJ. Physiology, Aldosterone. In: StatPearls. 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