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BioMed Research International
Volume 2015, Article ID 360209, 6 pages
http://dx.doi.org/10.1155/2015/360209
Clinical Study

Umbilical Neutrophil Gelatinase-Associated Lipocalin Level as an Early Predictor of Acute Kidney Injury in Neonates with Hypoplastic Left Heart Syndrome

1Department of Neonatology, Chair of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Medykow 14, 40-752 Katowice, Poland
2Department of Nephrology, Endocrinology and Metabolic Diseases, School of Medicine in Katowice, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, Poland

Received 7 July 2014; Revised 12 November 2014; Accepted 18 November 2014

Academic Editor: Jareen K. Meinzen-Derr

Copyright © 2015 Piotr Surmiak et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute kidney injury (AKI) is a primarily described complication after unbalanced systemic perfusion in neonates with congenital heart defects, including hypoplastic left heart syndrome (HLHS). The aim of the study was to compare the umbilical NGAL concentrations between neonates born with HLHS and healthy infants, as well as to analyze whether the determination of NGAL level could predict AKI in neonates with prenatally diagnosed HLHS. Twenty-one neonates with prenatally diagnosed HLHS were enrolled as study group and 30 healthy neonates served as controls. Perinatal characteristics and postnatal parameters were extracted from the hospital neonatal database. In umbilical cord blood, we determined plasma NGAL concentrations, acid base balance, and lactate and creatinine levels. In neonates with HLHS, complications (respiratory insufficiency, circulatory failure, NEC, IVH, and AKI) were recorded until the day of cardiosurgery. We observed in neonates with HLHS higher umbilical NGAL levels compared to controls. Among 8 neonates with HLHS and diagnosed AKI stage 1, we observed elevated NGAL levels in comparison to those newborns without AKI. Umbilical NGAL could predict, with high sensitivity and specificity, AKI development in study neonates. We suggest that the umbilical blood NGAL concentration may be an early marker to predict AKI in neonates with HLHS.