1081 Levels of Serum N-Terminal Pro-Brain Natriuretic Peptide, Cystatin C, and Urinary B2 Microglobulin in Newborns with Hypoxic Ischemic Encephalopathy

Abstract

Background and Aim Levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP), cystatin-C ve urinary beta2 microglobulin in newborns with hypoxic ischemic encephalopathy (HIE) were examined in this study. Methods In this study, 25 infants diagnosed with HIE were evaluated prospectively. The diagnosis was made according to criterias of American Gynaecelogy and Obstetric Academy (ACOG, 2003). Serum creatinine, NT-proBNP, cystatin C and urinary beta2 microglobulin in all patients were measured on the 1st and 5th days of hospitalization. Results The mean gestational age was 38.7 weeks and the birth weight was 3255 grams. Patients were classified as stage-1 (n=5), stage-2 (n=15) and stage-3 (n=5) HIE according to Sarnat classification. Therapeutic hypothermia was established in 6 patients. Acute renal failure (ARF) developed in 3 cases with stage 3 HIE. Peritoneal dialysis was performed for 2 of them. First day serum creatinine levels were higher than the 5th day levels (p=0.01). NT-proBNP and cystatin-C levels was significantly lower on the fifth day (p=0.01). Although not statistically significant, urinary beta2 microglobulin (mg/g cre) levels on the 1st day were higher than the 5th day (p=0.40). On the first day of hospitalization, a statistically significant correlation between NT-proBNP and creatinine (p=0.02), cystatin- C (p=0.01) and urinary beta2 microglobulin levels (p=0.01) were determined. NT-proBNP and cystatin-C levels were significantly high on the first day in infants developing ARF. Conclusion It may be beneficial to evaluate serum N-terminal proBNP ve cystatin-C with creatinin levels in HIE patients for the diagnosis, severity and follow-up of ARF.