ABSTRACT
To evaluate the role of urinary beta-2 microglobulin (B2mG) as an early predictive biomarker of acute kidney injury (AKI) in neonates with perinatal asphyxia. In this prospective cohort study, 80 term infants with perinatal asphyxia were included. The neonates were divided into AKI and no-AKI groups. Urinary B2mG levels were measured at 24 h of life. The diagnostic efficacy of the biomarker was determined using receiver operating characteristic (ROC) curves. Compared to infants without AKI, infants with AKI had higher levels of urinary B2mG (mean 6.8 versus 2.6 mg/L, p < 0.001). Area under the receiver operating characteristic curve (ROC curve) was 0.944. The balanced sensitivity/specificity trade-off was found at a cut-off value of 3.8 mg/L (81% sensitive and 81.6% specific).Conclusion Urinary B2mG can be useful to predict AKI early in term neonates with perinatal asphyxia. What is Known: ⢠AKI is seen in 20-40% of neonates with asphyxia. ⢠AKI affects the treatment plan and the prognosis of such neonates. What is New: ⢠Urinary biomarkers are the easiest way to diagnose AKI in asphyxiated neonates. ⢠Beta 2 microglobulin is the cheapest and readily available one such urinary biomarker with good sensitivity and specificity.
Subject(s)
Acute Kidney Injury , Asphyxia Neonatorum , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , Asphyxia , Asphyxia Neonatorum/complications , Asphyxia Neonatorum/diagnosis , Biomarkers , Female , Humans , Infant, Newborn , Pregnancy , Prospective Studies , ROC Curve , beta 2-MicroglobulinABSTRACT
There has been a growing interest among neonatologists and paediatricians regarding identification and evaluation of hypertension in the neonatal period. Despite the emergent normative data on blood pressure values in term and preterm neonates over the last two decades, there is still controversy regarding correct definition and classification of hypertension. This article will discuss the current definitions, available normative data and etiology of neonatal hypertension. There is paucity of records in terms of efficacy of antihypertensive drugs in this specific population and management is usually experience based, causing considerable heterogeneity amongst different units. This review article will also cover the evaluation, management, outcomes and follow up of neonatal hypertension with latest advances in this field.
