Fluid requirements during the first day of life in an anuric term infant who has renal parenchymal injury due to perinatal asphyxia are approximately:

• A. 50 mL/kg/day
• B. 80 mL/kg/day
• C. 100 mL/kg/day
• D. 30 mL/kg/day

Answer: (D)

In an anuric term infant with renal parenchymal injury from perinatal asphyxia, the kidneys cannot excrete water effectively. The main goal is to avoid fluid overload while maintaining enough perfusion, recognizing that any excess fluid will accumulate because there is little to no urine output. On the first day of life, this typically means a very conservative fluid plan. About 30 mL per kilogram per day is used as a rough target to cover essential needs and insensible losses (skin and respiratory) without risking edema or pulmonary congestion. As renal function begins to recover and urine output resumes, the fluid plan can be adjusted upward to match actual losses. This is in contrast to normal maintenance needs in healthy newborns, which are higher, but must be tempered in the setting of anuric AKI to prevent fluid overload.