Predicting Severity of Acute Kidney Injury in Term Neonates with Perinatal Asphyxia Using Urinary Neutrophil Gelatinase Associated Lipocalin.
OBJECTIVE
To evaluate the utility of urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) as a biomarker for predicting Acute Kidney Injury (AKI) and its severity among neonates with perinatal asphyxia.


METHODS
This descriptive study included 120 term neonates with perinatal asphyxia. Renal parameters of neonates were monitored and AKI was ascertained as per Acute Kidney Injury Network criteria. Urinary NGAL was estimated and correlated with severity of AKI.


RESULTS
Among the 120 neonates with perinatal asphyxia, 55(46 %) had AKI. The median urinary NGAL level was 165 ng/ml (88.8-245.8) in neonates with AKI compared to 58.97(42.8-74.7) in those without AKI. The median NGAL was 134.45(112.2-162.5), 301.2(255.5-361.2), 416.2(412.2-465.5) in AKI stages 1, 2 and 3 respectively. An NGAL cut off value of 86.82 ng/ml had 87 % sensitivity and 87.7 % specificity in predicting AKI.


CONCLUSIONS
Urinary NGAL is a useful biomarker for predicting AKI and its severity among neonates with perinatal asphyxia.
Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India.
Vasanthan
V
Tanigasalam
Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India. drvishnubhat@yahoo.com.
Ballambattu Vishnu
BV
Bhat
Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India.
Bethou
B
Adhisivam
Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Magadi Gopalakrishna
MG
Sridhar
Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Kottyen Thazath
KT
Harichandrakumar
D058186:Acute Kidney Injury / Q000175:diagnosis*; D000209:Acute-Phase Proteins; D001237:Asphyxia; D015415:Biomarkers; D006801:Humans; D007231:Infant, Newborn; D000071068:Lipocalin-2 / Q000652:urine*; D054834:Lipocalins; D011518:Proto-Oncogene Proteins
D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins
AKI; Acute kidney injury; Biomarker; Neonate; Perinatal asphyxia; Urinary NGAL