title: Urinary markers of acute kidney injury in newborns with perinatal asphyxia (.).
abstract: BACKGROUND
  Acute kidney injury (AKI) affects up to 60% of severely asphyxiated neonates. The diagnosis of AKI can be and is further challenged by a lack of good biomarkers. We studied the role of novel markers for AKI, neutrophil gelatinase-associated lipocalin (NGAL), interleukin-8 (IL-18), Netrin-1 (NTN-1), and sodium hydrogen exchanger isoform 3 (NHE3) on development and early diagnosis of AKI in newborns with perinatal asphyxia (PA).
  
  
  METHODS
  Forty-one newborns with a diagnosis of PA (15 with AKI and 26 without AKI) and 20 healthy matched controls were involved to the study. Urinary samples were obtained on postnatal days 1 and 4 for patients with PA and on postnatal day 1 for the control subjects. AKI was defined using a serum creatinine-based modification of the acute kidney injury network criteria.
  
  
  RESULTS
  The levels of NGAL, NTN-1, NHE3, and IL-18 on the first postnatal day urine samples were higher in patients compared to controls (p < 0.001, p <0.001, p  <0.02, p  <0.001, respectively). In patients with AKI, the levels of NGAL and IL-18 were higher when compared to patients without AKI (p = 0.002, p  <0.001, respectively). The levels of NTN-1 and NHE3 were similar in both groups. For the samples obtained on postnatal day 4, only NGAL levels were significantly higher in patients with AKI (p = 0.004) compared to those without AKI.
  
  
  CONCLUSIONS
  To our knowledge, this is the largest study, which evaluated the utility of urinary biomarkers in the diagnosis of AKI in newborns with PA. First day, urine NGAL and IL-18 levels have an important diagnostic power in such patients.
authors.affiliation: a Division of Neonatology , Zekai Tahir Burak Maternity Teaching Hospital , Ankara , Turkey.
authors.forename: Mehmet Yekta
authors.initials: MY
authors.lastname: Oncel
authors.affiliation: a Division of Neonatology , Zekai Tahir Burak Maternity Teaching Hospital , Ankara , Turkey.
authors.forename: Fuat Emre
authors.initials: FE
authors.lastname: Canpolat
authors.affiliation: a Division of Neonatology , Zekai Tahir Burak Maternity Teaching Hospital , Ankara , Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Arayici
authors.affiliation: a Division of Neonatology , Zekai Tahir Burak Maternity Teaching Hospital , Ankara , Turkey.
authors.forename: Evrim
authors.initials: E
authors.lastname: Alyamac Dizdar
authors.affiliation: a Division of Neonatology , Zekai Tahir Burak Maternity Teaching Hospital , Ankara , Turkey.
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
authors.affiliation: a Division of Neonatology , Zekai Tahir Burak Maternity Teaching Hospital , Ankara , Turkey.
authors.forename: Serife Suna
authors.initials: SS
authors.lastname: Oguz
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000652:urine*; D001237:Asphyxia / Q000150:complications / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D020382:Interleukin-18 / Q000652:urine*; D000071068:Lipocalin-2 / Q000652:urine*; D008297:Male; D009414:Nerve Growth Factors / Q000652:urine*; D000075388:Netrin-1; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D000074083:Sodium-Hydrogen Exchanger 3; D017923:Sodium-Hydrogen Exchangers / Q000652:urine*; D025521:Tumor Suppressor Proteins / Q000652:urine*; D014421:Turkey
chemical_list: D015415:Biomarkers; D020382:Interleukin-18; D000071068:Lipocalin-2; C000617351:NTN1 protein, human; D009414:Nerve Growth Factors; C000613385:SLC9A3 protein, human; D000074083:Sodium-Hydrogen Exchanger 3; D017923:Sodium-Hydrogen Exchangers; D025521:Tumor Suppressor Proteins; D000075388:Netrin-1; D003404:Creatinine
keywords: Acute kidney injury; Na+/H+ exchanger isoform 3; Netrin-1; interleukin-18; neutrophil gelatinase-associated lipocalin; perinatal asphyxia