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

Essajee, Farida; Were, Fred; Admani, Bashir

doi:10.1007/s00467-014-3035-9

Cited by 30 publications

(23 citation statements)

References 24 publications

(32 reference statements)

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“…The study by Admani et al [1] provides some novel information to the field. Similar to the cardiac surgery research paradigm, Admani et al [1] leveraged the known perinatal timing of and exposure to asphyxia to prospectively assess for AKI development by SCr, as well as to assess the ability of NGAL to predict SCr-based AKI and to define AKI itself.…”

Section: Scr As a Late Functional Marker Of Akimentioning

confidence: 99%

“…Similar to the cardiac surgery research paradigm, Admani et al [1] leveraged the known perinatal timing of and exposure to asphyxia to prospectively assess for AKI development by SCr, as well as to assess the ability of NGAL to predict SCr-based AKI and to define AKI itself. These authors demonstrate that newborns' NGAL level has a moderate discriminatory power to predict SCr-based AKI with an AUC of 0.72.…”

Section: Scr As a Late Functional Marker Of Akimentioning

confidence: 99%

“…Given the confounding of maternal SCr, the low muscle mass of newborns and the developmental increase in GFR seen over the first year of life, the ability to detect AKI independent of SCr would be a major boon to pediatric care. Admani and colleagues [1] should be commended for extrapolating the previous AKI work into a new patient population, correctly focusing on a subset of the newborn population with an identifiable time of insult and high morbidity associated with AKI [26]. Further work should build upon theirs to ascertain whether or not we can define AKI, as they have, by novel AKI damage biomarkers in other newborn populations.…”

Section: Scr As a Late Functional Marker Of Akimentioning

confidence: 99%

“…Admani and colleagues [1] report on a prospective cohort evaluation of acute kidney injury (AKI)-associated outcomes in 108 asphyxiated newborns at two tertiary care centers in Nairobi, Africa. In their study, the authors use the novel urinary AKI biomarker, neutrophil gelatinase associated lipocalin (NGAL) not only to predict the development of serum creatinine (SCr)-based AKI, but also to define AKI, establishing an NGAL threshold concentration (250 ng/ml) to demonstrate that NGAL-AKI itself is associated with poor outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Urinary NGAL to define AKI in asphyxiated infants

Goldstein

2015

Pediatr Nephrol

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Acute kidney injury (AKI) is independently associated with poor outcomes in the critically ill patient. The standard kidney function biomarker, serum creatinine, shows a demonstrable rise in concentration many hours to days after insult to the kidney. Thus, creatinine-based AKI diagnosis is likely delayed, rendering treatments to mitigate or prevent AKI ineffective. Neonatal AKI is further confounded by the fact that infant serum creatinine concentrations reflect maternal levels. The past 15 years has seen a massive research effort to identify early damage markers of AKI, with the hope that earlier "sub-clinical" AKI diagnosis can lead to earlier initiation of AKI treatment, or to adjustment of care to mitigate the adverse effects of AKI until renal function recovery occurs. One of the most promising urinary AKI biomarkers, neutrophil gelatinase associated lipocalin (NGAL), has repeatedly performed well to predict AKI in many pediatric populations, including those post-cardiac surgery, critically ill mechanically ventilated children and children arriving to the emergency department. The study reported by Admani et al. uses NGAL not only to predict serum creatinine-based AKI, but also to define AKI to associate a Day 1 NGAL concentration above a specific threshold with clinical outcomes.

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Section: Scr As a Late Functional Marker Of Akimentioning

confidence: 99%

Section: Scr As a Late Functional Marker Of Akimentioning

confidence: 99%

Section: Scr As a Late Functional Marker Of Akimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Urinary NGAL to define AKI in asphyxiated infants

Goldstein

2015

Pediatr Nephrol

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“…Several cutoff points ranging from 80 to 550 ng/mL have been used to determine the best sensitivity and specificity of urine NGAL. Cutoff for uNGAL levels have been reported as 18.6 ng/mL by Sarafidis et al, 29 and 250 ng/mL by Essajee F et al 30 Our cutoff for uNGAL was 75.1 ng/mL.…”

Section: Discussionmentioning

confidence: 53%

Urinary markers of acute kidney injury in newborns with perinatal asphyxia^*

et al. 2016

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Background: Acute kidney injury (AKI) affects up to 60% of severely asphyxiated neonates. The diagnosis of AKI can be and is further challenged by a lack of good biomarkers. We studied the role of novel markers for AKI, neutrophil gelatinase-associated lipocalin (NGAL), interleukin-8 (IL-18), Netrin-1 (NTN-1), and sodium hydrogen exchanger isoform 3 (NHE3) on development and early diagnosis of AKI in newborns with perinatal asphyxia (PA). Methods: Forty-one newborns with a diagnosis of PA (15 with AKI and 26 without AKI) and 20 healthy matched controls were involved to the study. Urinary samples were obtained on postnatal days 1 and 4 for patients with PA and on postnatal day 1 for the control subjects. AKI was defined using a serum creatininebased modification of the acute kidney injury network criteria. Results: The levels of NGAL, NTN-1, NHE3, and IL-18 on the first postnatal day urine samples were higher in patients compared to controls (p < 0.001, p <0.001, p <0.02, p <0.001, respectively). In patients with AKI, the levels of NGAL and IL-18 were higher when compared to patients without AKI (p ¼ 0.002, p <0.001, respectively). The levels of NTN-1 and NHE3 were similar in both groups. For the samples obtained on postnatal day 4, only NGAL levels were significantly higher in patients with AKI (p ¼ 0.004) compared to those without AKI. Conclusion: To our knowledge, this is the largest study, which evaluated the utility of urinary biomarkers in the diagnosis of AKI in newborns with PA. First day, urine NGAL and IL-18 levels have an important diagnostic power in such patients.

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A comparative proteomic analysis for non‐invasive early prediction of hypoxic‐ischemic injury in asphyxiated neonates

Gurtoo,

Karthikkeyan,

Behera

et al. 2023

Proteomics Clinical Apps

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AimHypoxic Ischemic Encephalopathy (HIE) is one of the principal causes of neonatal mortality and long‐term morbidity worldwide. The neonatal signs of mild cerebral injury are subtle, making an early precise diagnosis difficult. Delayed detection, poor prognosis, and lack of specific biomarkers for the disease are increasing mortality rates. In this study, we intended to identify specific biomarkers using comparative proteomic analysis to predict the severity of perinatal asphyxia so that its outcome can also be prevented.Experimental DesignA case‐control study was conducted on 38 neonates, and urine samples were collected within 24 and 72 h of life. A tandem mass spectrometry‐based quantitative proteomics approach, followed by validation via sandwich ELISA, was performed.ResultsThe LC‐MS/MS‐based proteomics analysis resulted in the identification of 1201 proteins in urine, with 229, 244, and 426 being differentially expressed in HIE‐1, HIE‐2, and HIE‐3, respectively. Axon guidance, Diseases of programmed cell death, and Detoxification of reactive oxygen species pathways were significantly enriched in mild HIE versus severe HIE. Among the differentially expressed proteins in various stages of HIE, we chose to validate four proteins – APP, AGT, FABP1, and FN1 – via sandwich ELISA. Individual and cumulative ROC curves were plotted. AGT and FABP1 together showed high sensitivity, specificity, and accuracy as potential biomarkers for early diagnosis of HIE.ConclusionEstablishing putative urinary biomarkers will facilitate clinicians to more accurately screen neonates for brain injury and monitor the disease progression. Prompt treatment of neonates may reduce mortality and neurodevelopmental impairment.

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

Abstract: 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.

Cited by 30 publications

References 24 publications

Urinary NGAL to define AKI in asphyxiated infants

Urinary NGAL to define AKI in asphyxiated infants

Urinary markers of acute kidney injury in newborns with perinatal asphyxia^*

A comparative proteomic analysis for non‐invasive early prediction of hypoxic‐ischemic injury in asphyxiated neonates

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

Abstract: 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.

Cited by 30 publications

References 24 publications

Urinary NGAL to define AKI in asphyxiated infants

Urinary NGAL to define AKI in asphyxiated infants

Urinary markers of acute kidney injury in newborns with perinatal asphyxia*

A comparative proteomic analysis for non‐invasive early prediction of hypoxic‐ischemic injury in asphyxiated neonates

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Urinary markers of acute kidney injury in newborns with perinatal asphyxia^*