The aim of this study is to determine the value of Pentoxifylline for nephroprotection in these neonates with perinatal asphyxia, using cystatin C, regional oxygenation measured near infrared spectroscopy and renal Doppler sonography.

Inclusion Criteria:

Inclusion criteria:

1. Evidence of perinatal hypoxia, as indicated by at least one of the following:

   1. Apgar score of less than or equal to 5 at 10 minutes.
   2. ongoing resuscitation at 10 minutes.
   3. pH less than 7.14 or a base deficit worse than or equal to minus 12 mmol/L on cord/arterial/venous/capillary blood gas obtained within 60 minutes of birth.

2. Evidence of moderate to severe encephalopathy using Sarnat staging score.(14)

3. Greater than or equal to 35 weeks gestational age.

4. Birth weight greater than or equal to 1800 g.

Exclusion Criteria:

Neonates with any of the following will be excluded:

1. Birth weight less than 1800 g. 2. Major congenital malformations/chromosomal anomalies including major cardiac anomalies. 3. Preterm less than 35 weeks gestational age according to modified Ballard score. (15) 4. progressive neuromuscular disorders (eg spinal muscle atrophy). 5. Severe systemic infections (eg TORCH infection).

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