Serum and urine acute kidney injury biomarkers in asphyxiated neonates

Pediatric Nephrology, 05/01/2012

Serum neutrophil gelatinase–associated lipocalin (NGAL) , urine cystatin C, and urine NGAL are sensitive, early acute kidney injury (AKI) biomarkers, increasing significantly in asphyxiated neonates even in those not fulfilling AKI criteria. Their measurement on day of life 1 is predictive of post–asphyxia–AKI.


  • AKI biomarkers were measured in 13 asphyxiated neonates born at ≥36 weeks gestational age (eight with AKI and five without AKI) and 22 controls.
  • AKI was defined as serum creatinine ≥1.5 mg/dl for >24 h or rising values >0.3 mg/dl from day of life (DOL) 1.
  • Biomarkers were measured on DOL 1, 3, and 10.


  • Asphyxiated neonates had significantly higher sCysC on DOL 1 as well as sNGAL and uCysC and uNGAL (standardized to urine creatinine and absolute values) than controls at all time points.
  • Compared to controls, significantly higher sNGAL, uCysC, and uNGAL values were observed in the asphyxia-AKI and asphyxia–no AKI subgroups.
  • Regarding uKIM-1, only the absolute values were significantly higher in asphyxiated neonates (DOL 10).
  • sNGAL, uCyst, and uNGAL had a significant diagnostic performance as predictors AKI on DOL 1.

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