ROLE OF URINARY NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN AS A BIOMARKER OF ACUTE KIDNEY INJURY IN LOW BIRTH WEIGHT INFANTS
Zaidatul Amalia,Syarifuddin Rauf,Dasril Daud,Ema Alasiry,Dwi Bahagia Febriani,Setia Budi Salekede
Department of Pediatrics Medical Faculty of Hasanuddin University Makassar Department of Pediatrics, Medical Faculty, Hasanuddin University, Makassar
Background : Acute kidney injury (AKI) in low birth weight (LBW) infants admitted to neonatal intensive care unit (NICU) is significantly associated with morbidity and mortality. Diagnosing AKI becomes a challenge in neonatal period. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a novel biomarker of AKI. However, its performance is still unclear. Aim of the study was to analyze role of uNGAL as a biomarker of AKI in LBW infants admitted to NICU.
Material : This cross sectional study involved LBW infants aged 48 hours to 28 days admitted to the NICU from July until August 2017. Blood and urine samples were obtained on admission to evaluate serum creatinine and uNGAL level. AKI was diagnosed using neonatal RIFLE criteria. uNGAL level were compared between AKI and non-AKI groups. Optimal cutt-off point, sensitivity, and specificity of uNGAL to diagnose AKI were calculated.
Results : A total of 59 LBW infants were enrolled and diagnosed as sepsis and respiratory distress of newborn. Twenty two (37.2%) patients had an evidence of AKI on admission. Fifteen (68.2%) of them were classified as RIFLE-risk. uNGAL level were significantly higher in AKI group than in non-AKI group with median value 1021.65 ng/mL and range 128.90-6033.50 ng/ml (p<0.01). Optimal cut-off point of uNGAL level as a biomarker of AKI in LBW infants was 129 ng/mL with 95.5% sensitivity; 91.9% specificity; 87.5% positive predictive value; 97.1% negative predictive value; and odds ratio 238.00 (CI 95 % 23.21- 2440.36).
Conclusions : uNGAL is a promising biomarker of AKI in LBW infants admitted to NICU.
Keywords: urinary neutrophil gelatinase-associated lipocalin acute kidney injury low birth weight infants neonatal intensive care unit
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