Abstract: Abstract: Objective To investigate the clinical value of urine neutrophil gelatinase-associated lipocalin (uNGAL) in the diagnosis and treatment of acute kidney injury after neonatal asphyxia. Methods A prospective study was conducted in the neonates hospitalized in our hospital for perinatal asphyxia from September 2016 to September 2017. According to whether acute kidney injury (AKI) occurred within 1 week after birth, they were divided into AKI group and non AKI group. Urine NGAL levels in 24 h after birth and serum levels of creatinine (Scr) and urea nitrogen (BUN) in 1 week after birth were detected and compared between two groups. The ROC curve was drawn to analyze the diagnostic value of uNGAL within 24 h after birth in AKI in neonatal asphyxia. Results A total of 114 cases of neonatal asphyxia were included in this study. There were 39 cases complicated with AKI, and the incidence was 34.2%. The incidence of AKI was 27.2% (24/88) in mild asphyxia group, which was significantly lower than that of the severe asphyxia group (57.69%, 15/26, P＜0.05). There were no significant differences in Scr and BUN levels of 24 h after birth between AKI group and non AKI group. Values of uNGAL and uNGAL/Ucr in 24 h after birth were significantly higher in AKI group than those of non AKI group (P＜0.05). In AKI group, there were 16 cases inⅠstage (crisis), 14 cases in Ⅱstage (damage) and 9 cases in Ⅲ stage (failure). There was significant difference in uNGAL in 24 h after birth between different stages of AKI patients. With the aggravation of AKI, the level of uNGAL gradually increased (P＜0.05). The ROC curve of AKI in neonatal asphyxia diagnosed by uNGAL within 24 h after birth was drawn. The area under the ROC curve (AUC) was calculated to be 0.842 (95%CI: 0.770-0.915, P＜0.01), the cut-off value was 118 μg/L, and the sensitivity was 87.2% and the specificity was 94.7%. Conclusion The uNGAL is a sensitive and specific index for early diagnosis of AKI after neonatal asphyxia. The increased level of uNGAL can reflect the severity of renal injury.

Key words: asphyxia neonatorum, acute renal injury, neutrophil gelatinase-associated lipocalin