title: Urine neutrophil gelatinase-associated lipocalin in asphyxiated neonates: a prospective cohort study.
abstract: 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).
  
  
  CONCLUSIONS
  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.affiliation: Aga Khan University Hospital, Nairobi, Kenya.
authors.forename: Farida
authors.initials: F
authors.lastname: Essajee
authors.forename: Fred
authors.initials: F
authors.lastname: Were
authors.forename: Bashir
authors.initials: B
authors.lastname: Admani
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D000209:Acute-Phase Proteins / Q000652:urine*; D001238:Asphyxia Neonatorum / Q000150:complications / Q000401:mortality / Q000652:urine*; D001724:Birth Weight; D001928:Brain Diseases, Metabolic / Q000209:etiology; D015331:Cohort Studies; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine*; D016019:Survival Analysis
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine