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

Tanigasalam, Vasanthan; Bhat, B. Vishnu; Adhisivam, B; Sridhar, Magadi Gopalakrishna; Harichandrakumar, K T

doi:10.1007/s12098-016-2178-z

Cited by 13 publications

(4 citation statements)

References 25 publications

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“…The included studies covered various backgrounds of AKI. Among them, 15 studies reported AKI occurred after CPB surgery ( 11 , 19 , 21 , 24 , 33 , 36 , 40 , 42 , 46 , 50 , 53 , 56 , 58 , 65 , 66 ), 12 studies reported AKI occurred in asphyxiated neonates ( 22 , 28 , 30 , 31 , 35 , 37 – 39 , 47 , 51 , 54 , 57 ), and the remaining 26 studies reported AKI occurred in children hospitalized for a variety of diseases, including sepsis, burns, solid tumors, post-liver transplantation, nephrotoxic drug use, imaging, and preterm, neonatal congenital heart disease, neonatal Hyperbilirubinemia, neonatal general surgery, etc. The diagnostic criteria for AKI used in the original studies varied and were mainly divided into the following three: pediatric risk, injury, failure, loss, final and end stage (PRIFLE) ( 67 ), Acute Kidney Injury Network (AKIN) ( 68 ) and Kidney Disease: Improving Global Outcomes (KDIGO) ( 69 ).…”

Section: Resultsmentioning

confidence: 99%

Predictive value of neutrophil gelatinase-associated lipocalin in children with acute kidney injury: A systematic review and meta-analysis

et al. 2023

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PurposeNeutrophil gelatin lipase carrier protein (NGAL) has been used as an early biomarker to predict acute kidney injury (AKI). However, the predictive value of NGAL in urine and blood in children with acute kidney injury in different backgrounds remains unclear. Therefore, we conducted this systematic review and meta-analysis to explore the clinical value of NGAL in predicting AKI in children.MethodsComputerized databases were searched for relevant the studies published through August 4th, 2022, which included PUBMED, EMBASE, COCHRANE and Web of science. The risk of bias of the original included studies was assessed by using the Quality Assessment of Studies for Diagnostic Accuracy (QUADA-2). At the same time, subgroup analysis of these data was carried out.ResultsFifty-three studies were included in this meta-analysis, involving 5,049 patients, 1,861 of whom were AKI patients. The sensitivity and specificity of blood NGAL for predicting AKI were 0.79 (95% CI: 0.69–0.86) and 0.85 (95% CI: 0.75–0.91), respectively, and SROC was 0.89 (95% CI: 0.86–0.91). The sensitivity and specificity of urine NGAL for predicting AKI were 0.83 (95% CI: 0.78–0.87) and 0.81 (95% CI: 0.77–0.85), respectively, and SROC was 0.89 (95% CI: 0.86–0.91). Meanwhile, the sensitivity and specificity of overall NGAL (urine and blood NGAL) for predicting AKI in children were 0.82 (95% CI: 0.77–0.86) and 0.82 (95% CI: 0.78–0.86), respectively, and SROC was 0.89 (95% CI: 0.86–0.91).ConclusionNGAL is a valuable predictor for AKI in children under different backgrounds. There is no significant difference in the prediction accuracy between urine NGAL and blood NGAL, and there is also no significant difference in different measurement methods of NGAL. Hence, NGAL is a non-invasive option in clinical practice. Based on the current evidence, the accuracy of NGAL measurement is the best at 2 h after cardiopulmonary bypass (CPB) and 24 h after birth in asphyxiated newborns.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022360157.

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Section: Resultsmentioning

confidence: 99%

Predictive value of neutrophil gelatinase-associated lipocalin in children with acute kidney injury: A systematic review and meta-analysis

et al. 2023

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“…Previous studies have reported a broad range of incidence of AKI after PNA, with rates as high as 55% to as low as 18.5% in neonates with PNA. [14][15][16][17][18] The AKI incidence rate was comparable to the earlier study by Zhang et al and Oncel et al 16,18 On the other hand, the rate of the present study was lesser than that observed by Tanigasalam et al and Abdelhady et al and higher than that observed by Tanzil et al and Essajee et al 16,15,17,14 Other than the small sample sizes, the variation may be due to variable definition of AKI across studies as well as the variation of the severity of PNA in the studies.…”

Section: Discussionmentioning

confidence: 99%

“…Though this was in agreement with other similar studies conducted in different countries, the uNGAL values differ significantly. [14][15][16][17][18] Further studies are essential to explain such variation in the uNGAL level among studies.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, ROC curve analysis suggested that the uNGAL cutoff value of 28.86 ng/ml on day in the studies, rendering thus the interpretation of the test problematic. [9][10][11][12][13][14][15][16][17][18] The differences in these studies could be related to the number of patients enrolled, the prevalence of the disease, and whether the study was designed primarily for identifying NGAL levels to diagnose AKI. The exciting finding of the present study is its AUC value which was 0.851.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Value of Urinary Neutrophil Gelatinase-Associated Lipocalin in Detecting Acute Kidney Injury in Asphyxiated Term Neonates

Hossain¹,

Biswas

Islam

et al. 2022

J Chittagong Med Coll Teachers Ass

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Background: Neonates with Perinatal Asphyxia (PNA) are at higher risk for developing Acute Kidney Injury (AKI). Conventionally, Serum Creatinine (SCr) is used to diagnose AKI but lacks specificity during the first few days of life. Neutrophil Gelatinase-Associated Lipocalin (NGAL) has emerged as a novel biomarker of AKI in such situations, while its value in our setting is yet to be validated. The study aimed to evaluate the role of urinary NGAL (uNGAL) level as a predictive biomarker of AKI in term newborn infants with PNA. Materials and methods: This prospective observational study included 55 full-term neonates with PNA from the Special Care Neonatal Unit of Chittagong Medical College Hospital.The uNGAL was measured by an enzyme-linked immunosorbent assay. Urinary samples were obtained for uNGAL on postnatal day 1(after 6 hours), and on day 3, blood samples for sCr were obtained on postnatal day1, 3 and 6. Results: Among 55 neonates with PNA, 20 (36.4%) had AKI. The mean ±SD uNGAL level was 97.77±17.13 ng/ml in neonates with AKI compared to 25.76±2.19 ng/ml in those without AKI in the first postnatal day. An uNGAL cutoff value of 28.86 ng/ml had 90.0% sensitivity and 82.9% specificity in predicting AKI the same day. The mean value of uNGAL was observed at a lower level, 54.53±14.72 ng/ml vs 15.17±2.18 ng/ml in AKI and no AKI neonates on third postnatal days. The cutoff value for detecting AKI was seen to be 26.43 ng/ml with high validity on this day. Significant differences in sCr were observed between AKI and no AKI measuring on days one and three, whereas the difference was not significant on day six. Conclusion: The study showed that uNGAL might be a valuable biomarker for predicting AKI among neonates with PNA. JCMCTA 2022 ; 33 (1) : 173-177

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Neutrophil gelatinase-associated lipocalin as predictor of acute kidney injury in neonates with perinatal asphyxia: a systematic review and meta-analysis

et al. 2018

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Serum and urinary NGAL represent candidate biomarkers with high performance in the prediction of acute kidney injury in newborns with perinatal asphyxia. Before NGAL can be widely used in clinical practice, future large prospective studies are needed to define the optimal cutoffs and accurately determine which levels are suggestive of post-asphyxial acute kidney injury. What is Known: • Acute kidney injury is a major cause of morbidity and mortality in perinatal asphyxia. • Current markers are insufficient in predicting post-asphyxial acute kidney injury. What is New: • Area under the curve for serum and urinary neutrophil gelatinase-associated lipocalin is 0.818 and 0.899, respectively. • Neutrophil gelatinase-associated lipocalin is a useful marker for detecting asphyxiated neonates at risk of developing acute kidney injury.

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

Abstract: Urinary NGAL is a useful biomarker for predicting AKI and its severity among neonates with perinatal asphyxia.

Cited by 13 publications

References 25 publications

Predictive value of neutrophil gelatinase-associated lipocalin in children with acute kidney injury: A systematic review and meta-analysis

Predictive value of neutrophil gelatinase-associated lipocalin in children with acute kidney injury: A systematic review and meta-analysis

Diagnostic Value of Urinary Neutrophil Gelatinase-Associated Lipocalin in Detecting Acute Kidney Injury in Asphyxiated Term Neonates

Neutrophil gelatinase-associated lipocalin as predictor of acute kidney injury in neonates with perinatal asphyxia: a systematic review and meta-analysis

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