ASSESSMENT OF SERUM NEUTROPHIL GELATINASE ASSOCIATED LIPOCALIN AS AN EARLY MARKER FOR ACUTE KIDNEY INJURY IN ASPHYXIATED NEONATES

Abstract

Background and objectives: Acute kidney injury (AKI) is a common complication of perinatal asphyxia (PA). Early detection of AKI is vital in asphyxiated neonates to help in early intervention and proper management. This study aimed to detect the level of serum Neutrophil Gelatinase Associated Lipocalin (NGAL) in neonates with perinatal asphyxia as an early indicator for acute kidney injury. Design and setting: This cross sectional - case control study included 60 neonates who were admitted in neonatal intensive care unit of Obstetric and Gynecology Hospital, Ain Shams University and Wadi El-Nil Hospital in the period from June 2014 to Juli 2015. Patients and Methods: The study included 60 neonates with perinatal asphyxia (33 patients with AKI and 27 neonates without AKI). Blood samples for NGAL levels were assessed by ELISA technique. Thirty age/ sex matched healthy controls served as reference for NGAL values. Results: Serum NGAL was statistically higher in patients group than healthy control group (p-value < 0.001). There was a statistically significant relation between Serum NGAL and each of hypoxic ischemic encephalopathy (HIE) severity, AKI and AKI staging in the studied patients. Regarding Receiver Operating Characteristic curve (ROC), the study revealed that the best cut off point between patients with and without AKI regarding serum NGAL was found >119.8 with sensitivity of 93.94%, specificity of 70.37% and area under curve (AUC) of 80.6%. Conclusion: NGAL can be considered as a sensitive diagnostic marker superior to both BUN, creatinine and GFR for early detection of acute kidney injury in neonates with perinatal asphyxia.