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CC BY 4.0 · Journal of Child Science 2023; 13(01): e104-e112
DOI: 10.1055/s-0043-1771517
Original Article

Early Predictor of Acute Kidney Injury in Newborns with Perinatal Asphyxia

Nafisa Hassan Refat 
1   Department of Pediatrics, Assiut University Children's Hospital, Assiut, Egypt
,
Mohamed Amir Fathy 
1   Department of Pediatrics, Assiut University Children's Hospital, Assiut, Egypt
,
Ali Hamdy Ali Abdel Hafez 
2   Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
,
Mohammed Abdeltawab Sabra 
1   Department of Pediatrics, Assiut University Children's Hospital, Assiut, Egypt
,
Enas Ahmad Hamed 
3   Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, Egypt
,
Yasser Farouk Abdelraheem 
1   Department of Pediatrics, Assiut University Children's Hospital, Assiut, Egypt
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Abstract

Acute kidney injury (AKI) is an independent risk factor for neonatal death. Since neonatal early renal injury usually has no specific clinical symptoms, many AKI cases are often missed the best time of early intervention if there is no relevant examination. Perinatal asphyxia (PA) can lead to AKI. The study aimed to assess efficacy of serum cystatin C (CystC) in early prediction of AKI in full-term neonates with PA. The study was conducted at the neonatal intensive care unit, Assiut University Children Hospital from January 2019 to January 2021. Seventy full-term neonates with documented PA were enrolled in the study. Baseline laboratory data and serum CystC levels were assessed. Out of those 70 neonates with PA, 21 (30%) developed AKI, while 49 (70%) neonates did not develop AKI. Majority of non-AKI group had stage-I hypoxic-ischemic encephalopathy (HIE) (61.2%), while majority of AKI had stage-III HIE (61.9%). A significantly higher serum CystC level was found among AKI group than those without AKI (1.50 ± 0.12 vs. 0.90 ± 0.14, p < 0.001). The predictors for AKI among neonates with PA were low birth weight, serum CystC levels, hypotension, and stage-III HIE. Serum CystC has 94.3% overall accuracy for prediction of AKI. In conclusion, AKI in neonates with PA is common. CystC is a promising biomarker in early prediction of AKI in such cases. Future studies are warranted to confirm these findings.

Keywords

acute kidney injury - accuracy - cystatin C - perinatal asphyxia - neonates

Authors' Contribution

N.H.R., M.A.F. and Y.F.A. conceptualized the work, analyzed, and interpreted, drew and reviewed the first draft and ensured for the integrity and accuracy in the work. A.H.A.A.H. and E.A.H. conceptualized the work, software, validation, visualization, investigation, reviewed the first draft, and ensured for the integrity and accuracy in the work. M.A.S. contributed to data curation, writing—original draft preparation, and ensured for the integrity and accuracy in the work. All the authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. These authors contributed equally to this work.




Publication History

Received: 07 April 2023

Accepted: 28 June 2023

Article published online:
02 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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