The value of urinary NGAL compared to serum creatinine level to predict acute kidney injury among neonate

Document Type: Original Article


1 Associate professor Iran university of medical sciences , Aliasghar hospital, Tehran ,Iran

2 Neonatologist, Iran University of medical Sciences

3 Pediatric Nephrologist, Iran University of medical Sciences

4 Student Research Committee, school of medicine, Iran University of Medical Sciences, Tehran, Iran



Background: The diagnosis of acute kidney injury(AKI) is based on calculating glomerular filtration rate rely on serum creatinine; however, this method seems to have some problems due to effects of underlying confounding parameters. Recent results identified NGAL as a sensitive marker to predict AKI in humans. The present study aimed to assess the change of the level of urinary NGAL in neonates with AKI and those without AKI.
Methods: This analytical cross-sectional study was performed on 75neonates who were hospitalized because of AKI and 81neonates who were hospitalized due to causes unrelated to kidney disease. In both groups the serum levels of creatinine and urine levels of NGAL were measured.
Results: The mean level of NGAL was 825.81±175.08ng/ml in case group and 292.20±322.03ng/ml in control group with a significant difference. NGAL had a sensitivity of 100%, specificity of 55.6%, PPV of 67.6%, NPV of 100%, and an accuracy of 76.9%to predict AKI. Assessing the area under the ROC curve showed that the measurement of NGAL could effectively discriminate AKI from normal condition (AUC=0.899). The best cutoff value for NGAL to predict AKI among neonates was estimated to be 427ng/ml yielding a sensitivity of 100% and a specificity of 67.9%. Using the Pearson’s correlation test showed a strong linear association between the level of NGAL and the changed level of creatinine (r=0.395, p