Neutrophil Gelatinase-Associated Lipocalin as a Useful Modality in Early Acute Kidney Injury Detection Amongst Low-Birth-Weight Neonates

Background: Chronic kidney disease (CKD) and hypertension in adolescence and young adulthood are predisposing factors for cardiovascular and neurological diseases later in life. Serum creatinine levels have been routinely used as a daily practice modality for detecting acute kidney injury (AKI) in patients of all ages, but unfortunately have some limitations, such as their delayed increase during AKI events. An earlier biomarker is needed to detect AKI, notably in the neonatal period. In the present study, we aimed to determine whether neutrophil gelatinase-associated lipocalin (NGAL) could be used as a modality in detecting AKI, not only in children and adults, but also in neonates. Methods: We conducted a prospective-cohort study on preterm neonates with a gestational age of 28–34 weeks at Hasan Sadikin General Hospital, Bandung, and performed serum NGAL and creatinine measurements. Spearman’s rank correlation was used to determine the association between serum NGAL levels and AKI during the first 48 h in these neonates. Serum NGAL was measured using the Elabscience® Human NGAL ELISA kit; NGAL positivity was defined as serum NGAL > 150 ng/mL for exploratory classification. Results: Serum NGAL measurement showed a better positivity rate in detecting early AKI in neonates than creatinine (KDIGO and nRIFLE), with values of 81.8, 24.7, and 10.4, respectively. Conclusions: NGAL can be used as a modality for detecting AKI earlier in neonates.