Clinical value of NGAL, copeptin and creatinine in hypoxic renal injury of full-term neonates with asphyxia

Objective To explore the clinical value of NGAL, peptide, and creatinine in the hypoxic renal injury of full-term neonates with asphyxia. Methods During June 2015 to October 2017, selected 48 full-term newborns from 1 000 babies born in our hospital, A prospective study was conducted on 48 full-term newborns. 9 asphyxiated neonates (18.6%) had AKI, while 38 had no AKI signs and 30 healthy infants. Umbilical cord blood and 24h after birth serum NGAL, creatinine, and peptide hormone were measured in all asphyxiated and controls neonates.Results The results showed that there are no differences in creatinine and peptide hormones levels, as well as serum osmotic pressure in all three investigated groups (AKI, no-AKI, and controls) in umbilical cord blood and 24h after birth. Compared with the non-AKI and control group, the serum NGAL level in umbilical cord blood was significantly higher than in the AKI group at 24h after birth. NGAL concentration showed a strong negative correlation to umbilical artery pH (ρ=-0.42, P=0.04), base excess (ρ=-0.31, P=0.03) and Apgar score in the first minute (ρ=-0.41, P=0.02) and 5 minutes of life (ρ=-0.20, P=0.20). The ROC curve analysis showed that NGAL level had a good predictive value (140.7 ng/mL), which could be used to diagnose the AKI of neonatal asphyxia. Conclusions NGAL is a very promising material, due to its high sensitivity, high specificity, can be used as the early oxygen deficiency of kidney damage prediction diagnostic markers, and peptide hormones and creatinine, however, does not meet expectations as a biomarker for predicting requirements.