Serum Neutrophil Gelatinase-Associated Lipocalin as a Biomarker of Acute Kidney Injury in Babies with Perinatal Asphyxia in Abia State, South-East Nigeria

<i>Introduction:</i> Acute Kidney Injury (AKI) is a major cause of mortality and long-term morbidity. It is a very common complication in asphyxiated newborns. Early detection of AKI in these cohort of patients will positively impact outcome. Serum Neutrophil Gelatin-associated lipocalin (NGAL) is a highly sensitive biomarker of AKI. There is paucity of data on the determination of the incidence of AKI in asphyxiated babies using Serum NGAL as a biomarker. <i>Objective:</i> This study was set to evaluate the use of serum NGAL measurement for early detection of AKI in babies with perinatal asphyxia at the Abia State University Teaching Hospital (ABSUTH), Aba. <i>Methods:</i> This was a cross-sectional descriptive study done at the Newborn Special Care Unit of ABSUTH, Aba, Nigeria. Serum NGAL estimation was done within the first six hours of delivery. Also, serum creatinine was done daily for the first week of admission. <i>Results: </i>A total of 155 term neonates with perinatal asphyxia were studied. The male to female ratio was 1.06:1. Among these neonates, 43.9% had mild, 29.0% had moderate and 27.1% had severe perinatal asphyxia respectively. The mean serum NGAL concentration in those with mild, moderate and severe perinatal asphyxia were 345.3ng/ml, 673.1ng/ml, and 866.1ng/ml, respectively. A statistically significant difference was observed in these mean serum NGAL concentrations (p value<0.05). The serum NGAL levels increased with the increasing severity of AKI. There was a higher serum NGAL concentration with a mean of 614.00±22ng/ml in patients with AKI (P<0.05). A cut-off value of 270ng/ml for serum NGAL using the receiver operating curve could detect AKI in asphyxiated neonates, with a sensitivity of 99.3%. The area under the curve of 1.0 was statistically significant. (p = 0.001) <i>Conclusion:</i> Serum NGAL is a highly sensitive biomarker of AKI. Serum NGAL levels measured within the first six hours after birth is elevated in patients with AKI. NGAL estimation in the first 6 hours of the birth of asphyxiated neonates is recommended for early detection of AKI.