Evaluation of Novel Biomarkers for Early Diagnosis of Acute Kidney Injury in Asphyxiated Full-Term Newborns: A Case-Control Study

• Published in: Medical principles and practice Vol. 29; no. 3; pp. 285 - 291
• Main Authors: Zhang, Ying, Zhang, Bili, Wang, Dan, Shi, Wujuan, Zheng, Anjie
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.05.2020
• Subjects: Accuracy; Acute Kidney Injury - blood; Acute Kidney Injury - etiology; Alpha-Globulins - analysis; Apgar score; Asphyxia Neonatorum - complications; beta 2-Microglobulin - blood; Biomarkers; Birth Weight; Blood Urea Nitrogen; Case-Control Studies; Creatinine; Creatinine - blood; Cystatins - blood; Female; Gestational Age; Humans; Infant, Newborn; Kidney diseases; Laboratories; Lipocalin-2 - blood; Male; Medical diagnosis; Methods; Molecular weight; Mortality; Neutrophils; Newborn babies; Original Paper; Pediatrics; Proteins; Severity of Illness Index; Umbilical cord; Urine; Asphyxia; Full-term neonates; Urinary neutrophil gelatinase-associated lipocalin; Acute kidney injury
• ISSN: 1011-7571; 1423-0151; 1423-0151
• DOI: 10.1159/000503555

Objectives: To investigate the changes of serum cystatin C (Cys-C), beta 2-microglobulin (β2-MG), urinary neutrophil gelatinase-associated lipocalin (NGAL), and alpha 1-microglobulin (α1-MG) in asphyxiated neonates, and to evaluate the value of combined detection of multiple biomarkers in the early diagnosis of acute kidney injury (AKI) in asphyxiated neonates. Methods: A total of 110 full-term asphyxiated and 30 healthy neonates were included. The asphyxia neonates were divided into AKI and non-AKI groups. Serum Cys-C, β2-MG, urine NGAL, and α1-MG were measured 24 h after birth. The diagnostic value of the biomarkers was determined using receiver operating characteristic (ROC) curves. Results: There was no significant difference in serum creatinine and blood urea nitrogen among the control group, moderate asphyxia group, and severe asphyxia group at 24 h after birth. Significant differences were noticed in terms of serum Cys-C, β2-MG, urinary NGAL, and α1-MG among the 3 groups. Moreover, with the aggravation of asphyxia, the above indicators gradually increased. There were significant differences in the 4 indicators between the AKI and non-AKI groups (p < 0.05). The area under the ROC curve of the above indicators was 0.670, 0.689, 0.865, and 0.617, respectively (p < 0.05). The sensitivity and specificity of the combined diagnosis of asphyxia neonatorum AKI with the 4 indicators were 0.974 and 0.506, respectively. Conclusions: Serum Cys-C, β2-MG, urine NGAL, and α1-MG are early specific indicators for the diagnosis of renal injury after neonatal asphyxia. Combined detection of these parameters could aid clinical evaluation of renal injury in asphyxiated neonates.