Lipokalin udružen s neutrofilnom gelatinazom kao rani biološki biljeg akutnog oštećenja bubrega u novorođenčadi

The aim of the study was to determine the incidence, risk factors and efficiency of the neutrophil gelatinase-associated lipocalin (NGAL) biomarker in early diagnosis of acute kidney injury (AKI) in newborns. The study was designed as a prospective, clinical, epidemiological investigation conducted in the period of three years, which included 50 newborns with AKI hospitalized in the Neonatal Intensive Care Unit, University Children’s Hospital in Skopje. The estimated prevalence of AKI was 6.4%, while the prevalence according to RIFLE classification was 8.7%. Perinatal asphyxia was a common predisposing factor associated to kidney injury. The mortality rate was 32% and was significantly higher in the group of newborns with congenital heart diseases. There was a significant difference between NGAL values and creatinine values on the day of admission. There was a significant difference in NGAL values between newborns with AKI and lethal outcome and newborns without lethal outcome (p<0.001). In conclusion, AKI is a life-threatening condition. It is an independent contributor to mortality. Urinary NGAL is an early predictive biomarker of AKI in critically ill newborns.Cilj istraživanja bio je utvrditi incidenciju, čimbenike rizika i učinkovitost biološkog biljega lipokalina udruženog s neutrofilnom gelatinazom (neutrophil gelatinase-associated lipocalin, NGAL) u ranoj dijagnostici akutnog oštećenja bubrega (AOB) kod novorođenčadi. Istraživanje je provedeno kao prospektivna klinička epidemiološka studija kroz razdoblje od tri godine, a obuhvatila je 50 novorođenčadi s AOB hospitalizirane u Neonatalnoj jedinici intenzivnog liječenja (NJIL) Sveučilišne dječje bolnice u Skopju. Procijenjena učestalost AOB bila je 6,4%, dok je učestalost prema klasifikaciji RIFLE iznosila 8,7%. Perinatalna asfiksija bila je čest predisponirajući čimbenik udružen s oštećenjem bubrega. Stopa smrtnosti bila je 32% i bila je značajno viša u skupini novorođenčadi s kongenitalnim srčanim bolestima. Utvrđena je značajna razlika među vrijednostima NGAL i kreatinina na dan prijma u NJIL. Značajna razlika zabilježena je u vrijednostima NGAL između novorođenčadi s AOB i smrtnim ishodom i novorođenčadi bez smrtnog ishoda (p