The value of urine NAG, NGAL combined with serum Cys-C in early diagnosis of neonatal hyperbilirubinemia-related acute kidney injury

Abstract

Objective: To explore the early diagnostic value of urinary NAG, NGAL and serum Cys-C detection for neonatal hyperbilirubinemia-related acute kidney injury (AKI) in full-term neonates with hyperbilirubinemia. Methodology: One hundred and ninety-six full-term jaundiced newborns were categorized as mild (n = 65), moderate (n = 69) or severe hyperbilirubinemia (n = 62). The severe group was divided into a non-AKI group (n = 35) and an AKI group (n = 27). Sixty-five full-term newborns with normal serum bilirubin and renal function were analyzed as a normal control group. Urine NAG, urine NGAL and serum Cys-C weremeasured. The value of urinary NAG, NGAL combined with serum Cys-C in early diagnosis of neonatal hyperbilirubinemia-related AKI was evaluated by Receiver Operating Characteristic Curve (ROC). Result: Levels of urine NAG, NGAL and serum Cys-C in the mild, moderateand severe groups were higher than those in the normal control group (p < 0.001), the above indexes levels in the severe group were higher than those in the mildand moderate groups (p < 0.001), and the above indexes levels in the moderate group were higher than those in the mild group (p < 0.001). Pearson correlation analysis showed that serum Cys-C was positively correlated with urinary NAG and urinary NGAL in AKI group (r = 0.805, p < 0.001; r = 0.864, p < 0.001); there was a positive correlation between urinary NAG and urinary NGAL in AKI group (r = 0.948, p < 0.001). AUC of urinary NAG, urinary NGAL combined with serum Cys-C in diagnosing neonatal hyperbilirubinemia-related AKI is 0.900 (95% CI: 0.824-0.976), which is higher than that of urinary NAG, urinary NGAL and serum Cys-C alone. Conclusion: Combined measurement of urine NAG, NGAL and serum Cys-C is helpful for early diagnosis of neonatal hyperbilirubinemia-related AKI.