Urine neutrophil gelatinase-associated lipocalin in asphyxiated neonates: a prospective cohort study
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Date
2015Author
Essajee, Farida
Were, Fred
Admani, Bashir
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
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.
Citation
Pediatric Nephrology July 2015, Volume 30, Issue 7, pp 1189-1196Publisher
Springer
Rights
Attribution-NonCommercial-ShareAlike 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-sa/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10387]
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