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Biomarkers of acute kidney injury in neonatal encephalopathy

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Abstract

Acute kidney injury (AKI) is a common complication of neonatal encephalopathy (NE). The accurate diagnosis of neonatal AKI, irrespective of the cause, relies on suboptimal methods such as identification of rising serum creatinine, decreased urinary output and glomerular filtration rate. Studies of AKI biomarkers in adults and children have shown that biomarkers can improve the early diagnosis of AKI. Hypoxia–ischaemia is the proposed aetiological basis of AKI in both NE and cardiopulmonary bypass (CPB). However, there is a paucity of studies examining the role of AKI biomarkers specifically in NE. Urinary cystatin C (CysC), neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18, kidney injury molecule-1, liver-type fatty acid-binding protein, serum CysC and serum NGAL all show good ability to predict early AKI in a heterogeneous critically ill neonatal population including infants post-CPB. Moreover, serum and urinary NGAL and urinary CysC are early predictors of AKI secondary to NE. These findings are promising and open up the possibility of biomarkers playing a significant role in the early diagnosis and treatment of NE-related AKI. There is an urgent need to explore the role of AKI biomarkers in infants with NE as establishing the diagnosis of AKI earlier may allow more timely intervention with potential for improving long-term outcome.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neonatology, National Maternity Hospital, Holles Street, Dublin, Ireland

    DU Sweetman & EJ Molloy

  2. Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland

    DU Sweetman & EJ Molloy

  3. Neonatology, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland

    EJ Molloy

  4. UCD School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland

    EJ Molloy

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Correspondence to DU Sweetman.

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Sweetman, D., Molloy, E. Biomarkers of acute kidney injury in neonatal encephalopathy. Eur J Pediatr 172, 305–316 (2013). https://doi.org/10.1007/s00431-012-1890-6

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