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Urine neutrophil gelatinase-associated lipocalin in asphyxiated neonates: a prospective cohort study

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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).

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.

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Acknowledgements

We express our sincere appreciation to Pumwani Maternity Hospital, Kenyatta National Hospital and Aga Khan University Hospital for providing the support and necessary resources to complete this study. We also thank Dr Sam Akech for his support during the study.

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Authors and Affiliations

  1. Aga Khan University Hospital, Nairobi, Kenya

    Farida Essajee

  2. Aga Khan University Hospital, University of Nairobi, Nairobi, Kenya

    Fred Were & Bashir Admani

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  1. Farida Essajee
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  2. Fred Were
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  3. Bashir Admani
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Correspondence to Bashir Admani.

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Essajee, F., Were, F. & Admani, B. Urine neutrophil gelatinase-associated lipocalin in asphyxiated neonates: a prospective cohort study. Pediatr Nephrol 30, 1189–1196 (2015). https://doi.org/10.1007/s00467-014-3035-9

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  • DOI: https://doi.org/10.1007/s00467-014-3035-9

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