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Predicting Severity of Acute Kidney Injury in Term Neonates with Perinatal Asphyxia Using Urinary Neutrophil Gelatinase Associated Lipocalin

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Abstract

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.

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Contributions

VT: Collected and analyzed the data; BVB: Designed and supervised study; BA: Drafted manuscript and critically analyzed data; MGS: Helped with lab investigations; KTH: Helped in data analysis. BVB will act as guarantor for the paper.

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Authors and Affiliations

  1. Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India

    Vasanthan Tanigasalam, Ballambattu Vishnu Bhat & Bethou Adhisivam

  2. Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India

    Magadi Gopalakrishna Sridhar

  3. Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India

    Kottyen Thazath Harichandrakumar

Authors
  1. Vasanthan Tanigasalam
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  2. Ballambattu Vishnu Bhat
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  3. Bethou Adhisivam
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  4. Magadi Gopalakrishna Sridhar
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  5. Kottyen Thazath Harichandrakumar
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Corresponding author

Correspondence to Ballambattu Vishnu Bhat.

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Source of Funding

Intramural research grant from JIPMER, Puducherry.

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Tanigasalam, V., Bhat, B.V., Adhisivam, B. et al. Predicting Severity of Acute Kidney Injury in Term Neonates with Perinatal Asphyxia Using Urinary Neutrophil Gelatinase Associated Lipocalin. Indian J Pediatr 83, 1374–1378 (2016). https://doi.org/10.1007/s12098-016-2178-z

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  • DOI: https://doi.org/10.1007/s12098-016-2178-z

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