BACKGROUND: Acute kidney injury (AKI) is the most common complication of perinatal asphyxia. Recent research indicates that urine neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI; yet, there is a paucity of data about its use in term neonates with perinatal asphyxia. METHODS: A prospective cohort study was conducted on 108 term babies in the new-born unit of Pumwani Maternity Hospital and Kenyatta National Hospital. Urine NGAL and serum creatinine were measured in 108 term asphyxiated neonates on days 1 and 3 of life. RESULTS: One-hundred and eight patients were recruited (male:female 1.4:1). At a cut-off of 250 ng/ml, urine NGAL had an acceptable discriminative capability of predicting AKI (area under the curve 0.724). The sensitivity, specificity, positive and negative predictive value and likelihood ratios were 88, 56, 30, 95%, 2 and 0.2 respectively. Urine NGAL levels were significantly higher in patients with AKI compared with those without AKI. An NGAL level greater than 250 ng/ml on day 1 was significantly associated with severe hypoxic ischaemic encephalopathy (HIE); odds ratio = 8.9 (95% CI 1.78-37.69) and mortality; odds ratio = 8.9 (95% CI 1.78-37.69). CONCLUSION: Urine NGAL is a good screening test for the early diagnosis of AKI. It is also a predictor of mortality and severity of HIE in asphyxiated neonates.
BACKGROUND:Acute kidney injury (AKI) is the most common complication of perinatal asphyxia. Recent research indicates that urine neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI; yet, there is a paucity of data about its use in term neonates with perinatal asphyxia. METHODS: A prospective cohort study was conducted on 108 term babies in the new-born unit of Pumwani Maternity Hospital and Kenyatta National Hospital. Urine NGAL and serum creatinine were measured in 108 term asphyxiated neonates on days 1 and 3 of life. RESULTS: One-hundred and eight patients were recruited (male:female 1.4:1). At a cut-off of 250 ng/ml, urine NGAL had an acceptable discriminative capability of predicting AKI (area under the curve 0.724). The sensitivity, specificity, positive and negative predictive value and likelihood ratios were 88, 56, 30, 95%, 2 and 0.2 respectively. Urine NGAL levels were significantly higher in patients with AKI compared with those without AKI. An NGAL level greater than 250 ng/ml on day 1 was significantly associated with severe hypoxic ischaemic encephalopathy (HIE); odds ratio = 8.9 (95% CI 1.78-37.69) and mortality; odds ratio = 8.9 (95% CI 1.78-37.69). CONCLUSION: Urine NGAL is a good screening test for the early diagnosis of AKI. It is also a predictor of mortality and severity of HIE in asphyxiated neonates.
Authors: Michael Bennett; Catherine L Dent; Qing Ma; Sudha Dastrala; Frank Grenier; Ryan Workman; Hina Syed; Salman Ali; Jonathan Barasch; Prasad Devarajan Journal: Clin J Am Soc Nephrol Date: 2008-03-12 Impact factor: 8.237
Authors: Jay L Koyner; Michael R Bennett; Elaine M Worcester; Qing Ma; Jai Raman; Valluvan Jeevanandam; Kristen E Kasza; Michael F O'Connor; David J Konczal; Sharon Trevino; Prasad Devarajan; Patrick T Murray Journal: Kidney Int Date: 2008-07-23 Impact factor: 10.612
Authors: Biljana Pejović; Jelena Erić-Marinković; Marija Pejović; Jelena Kotur-Stevuljević; Amira Peco-Antić Journal: Biochem Med (Zagreb) Date: 2015-10-15 Impact factor: 2.313
Authors: Simona Riccio; Maria Sole Valentino; Antonio Paride Passaro; Marica Izzo; Stefano Guarino; Emanuele Miraglia Del Giudice; Pierluigi Marzuillo; Anna Di Sessa Journal: Children (Basel) Date: 2022-01-17