title: Umbilical neutrophil gelatinase-associated lipocalin level as an early predictor of acute kidney injury in neonates with hypoplastic left heart syndrome.
abstract: Acute kidney injury (AKI) is a primarily described complication after unbalanced systemic perfusion in neonates with congenital heart defects, including hypoplastic left heart syndrome (HLHS). The aim of the study was to compare the umbilical NGAL concentrations between neonates born with HLHS and healthy infants, as well as to analyze whether the determination of NGAL level could predict AKI in neonates with prenatally diagnosed HLHS. Twenty-one neonates with prenatally diagnosed HLHS were enrolled as study group and 30 healthy neonates served as controls. Perinatal characteristics and postnatal parameters were extracted from the hospital neonatal database. In umbilical cord blood, we determined plasma NGAL concentrations, acid base balance, and lactate and creatinine levels. In neonates with HLHS, complications (respiratory insufficiency, circulatory failure, NEC, IVH, and AKI) were recorded until the day of cardiosurgery. We observed in neonates with HLHS higher umbilical NGAL levels compared to controls. Among 8 neonates with HLHS and diagnosed AKI stage 1, we observed elevated NGAL levels in comparison to those newborns without AKI. Umbilical NGAL could predict, with high sensitivity and specificity, AKI development in study neonates. We suggest that the umbilical blood NGAL concentration may be an early marker to predict AKI in neonates with HLHS.
authors.affiliation: Department of Neonatology, Chair of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland.
authors.forename: Piotr
authors.identifier: 0000-0003-3662-634X
authors.initials: P
authors.lastname: Surmiak
authors.affiliation: Department of Neonatology, Chair of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland.
authors.forename: Małgorzata
authors.identifier: 0000-0003-4865-7274
authors.initials: M
authors.lastname: Baumert
authors.affiliation: Department of Neonatology, Chair of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland.
authors.forename: Małgorzata
authors.identifier: 0000-0001-5591-3956
authors.initials: M
authors.lastname: Fiala
authors.affiliation: Department of Neonatology, Chair of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Walencka
authors.affiliation: Department of Nephrology, Endocrinology and Metabolic Diseases, School of Medicine in Katowice, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Więcek
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000150:complications / Q000473:pathology; D000209:Acute-Phase Proteins; D005312:Fetal Blood; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000097:blood* / Q000150:complications / Q000473:pathology; D007231:Infant, Newborn; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D011518:Proto-Oncogene Proteins / Q000097:blood*
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins