Pakistan Journal of Biological Sciences1028-88801812-5735Asian Network for Scientific Information10.3923/pjbs.2012.231.237El-FarghaliO. G.El-RaggalN. M.MahmoudN. H.ZainaG. A.52012155Early detection of evolving Acute Kidney Injury (AKI) in critically
ill neonates can lead to better preventive and therapeutic interventions. Neutrophil
Gelatinase-associated Lipocalin (NGAL) is a promising biomarker of AKI, which
was also shown to increase in inflammation. The objective of this study was
to assess the utility of serum NGAL (sNGAL) as an early marker of evolving AKI
in critically-ill neonates with and without sepsis. sNGAL levels were estimated
in 60 critically-ill neonates at the time of admission to Neonatal Intensive
Care Unit (NICU), in comparison to 20 healthy matched control. Patients were
categorized as sepsis (n = 35) and no-sepsis (n = 25) subgroups on basis of
clinical and laboratory criteria. They were subsequently discriminated according
to creatinine and urine output criteria of the Acute Kidney Injury Network (AKIN),
into AKI (n = 34) and no-AKI (n = 26) subgroups. sNGAL levels were significantly
higher in the patient group as compared to control (132.7±67.8 vs. 55±10.3
ng mL-1, p = 0.0001). Elevated levels were comparable between sepsis
and no-sepsis groups (130.1±69.4 vs. 136.5±66.6 ng mL-1,
p = 0.7) and they positively correlated with 48-hour post-admission serum creatinine
(p = 0.0001). Patients of AKI group had significantly higher sNGAL than those
of no-AKI group (176.2±55.9 vs. 75.9±28.3 ng mL-1,
p = 0.0001). A cut-off value for sNGAL of 117.5 ng mL-1, was predictive
of AKI with a sensitivity of 82% and a specificity of 88.5%. It could be speculated
that measurement of serum NGAL can serve as a clinically useful marker for early
prediction of evolving AKI in critically-ill neonates with and without sepsis.]]>Aggarwal, A., P. Kumar, G. Chowdhary, S. Majumdar and A. Narang,200551295299Andreoli, S.P.,200428112123Askenazi, D.J., N. Ambalavanan and S.L. Goldstein,200924265274Bagshaw, S.M., R. Bellomo, P. Devarajan, C. Johnson and C.J. Karvellas et al., 201057985998Bagshaw, S.M., M. Bennet, M. Haase, A. Haase-Fielitz and M. Egi et al.,201036452461Bagshaw, S.M., C. George, R. Bellomo and ANZICS Database Management Committee,20082008Cruz, D.N., M. de Cal, F. Garzotto, M.A. Perazella and P. Lentini et al.,201036444451Dent, C.L., Q. Ma, S. Dastrala, M. Bennett, M.M. Mitsnefes, J. Barasch and P. Devarajan,20072007Devarajan, P., 20104265280Gabbard, W., E.B. Milbrandt and J.A. Kellum,201014318318Goetz, D.H., M.A. Holmes, N. Borregaard, M.E. Bluhm, K.N. Raymond and R.K. Strong,20021010331043Guerin, C., R. Girard, J.M. Selli, J.P. Perdrix and L. Ayzak,2000161872879Gupta, B.D., P. Sharma, J. Bagla, M. Parakh and J.P. Soni,200542928934Haase, M., R. Bellomo, P. Devarajan, P. Schlattmann and A. Haase-Fielitz,20095410121024Haase-Fielitz, A., R. Bellomo, P. Devarajan, D. Story, G. Matalanis, D. Dragun and M. Haase,200937553560Hirsch, R., C. Dent, H. Pfriem, J. Allen and R.H. Beekman et al.,20072220892095Huynh, T.K., D.A. Bateman, E. Parravicini, J.M. Lorenz and S.L. Nemerofsky et al.,200966528532Kalousek, I., P. Roselova and P. Otevrelova,2006145373376Koyner, J.L., M.R. Bennett, E.M. Worcester, Q. Ma and J. Raman et al.,20087410591069Krawczeski, C.D., J.G. Woo, Y. Wang, M.R. Bennett, Q. Ma and P. Devarajan,201115810091015Lavery, A.P., J.K. Meinzen-Derr, E. Anderson, Q. Ma, M.R. Bennett and P. Devarajan,200864423428Xiao-yu, L., Z. Xin, W. Ying and D. Jie,20116275279Makris, K., N. Markou, E. Evodia, E. Dimopoulou and I. Drakopoulos et al.,2009477982Mathur, N.B., H.S. Agarwal and A. Maria,200673499502Mehta, R.L., J.A. Kellum, S.V. Shah, B.A. Molitoris and C. Ronco et al.,20072007Miklaszewska, M., J.A. Pietrzyk, K. Zachwieja, D. Drozdz and W. Sulowicz,2006638184Mishra, J., C. Dent, R. Tarabishi, M.M. Mitsnefes and Q. Ma et al.,200536512311238Mishra, J., Q. Ma, A. Prada, M. Mitsnefes and K. Zahedi et al.,20031425342543Mussap, M., R. Degrandi, M. Fravega and V. Fanos,2010237072Niemann, C.U., A. Walia, J. Waldman, M. Davio, J.P. Roberts, R. Hirose and J. Feiner,20091518521860Parravicini, E., 201022146150Schmidt-Ott, K.M., K. Mori, A. Kalandadze, J.Y. Li and N. Paragas et al.,200615442449Siew, E.D., L.B. Ware, T. Gebretsadik, A. Shintani and K.G.M. Moons et al.,20092018231832Smith, E.R., D. Zurakowski, A. Saad, R.M. Scott and M.A. Moses,20081423782386Soni, S.S., D. Cruz, I. Bobek, C.Y. Chionh and F. Nalesso et al.,201042141150Sveger, T., K. Ohlsson, H. Morse, S. Polberger and S. Laurin,2003638992Tuladhar, S.M., V.O. Puntmann, M. Soni, P.P. Punjabi and R.G. Bogle,200953261266Uttenthal, L.O.,2005293941Venkataraman, R. and J.A. Kellum,200722187193Wasilewska, A., K. Taranta-Janusz, W. Debek, W. Zoch-Zwierz and E. Kuroczycka-Saniutycz,201126579586Wheeler, D.S., P. Devarajan, Q. Ma, K. Harmon, M. Monaco, N. Cvijanovich and H.R. Wong,20083612971303Workeneh, B.T.,20112011Xu, S.Y., K. Pauksen and P. Venge,199555125131Zappitelli, M.,K.K. Washburn, A.A. Arikan, L. Loftis and Q. Ma et al.,20072007