Urinary neutrophil gelatinase-associated lipocalin in acute tubular injury among children with severe gastroenteritis

Abstract

Background Acute kidney injury (AKI) is a serious complication in critically ill children. It is a risk factor for mortality, prolonged stays in the ICU, and prolonged mechanical ventilation. Objectives To investigate urinary neutrophil gelatinase-associated lipocalin (NGAL) concentrations as an early biomarker of prerenal AKI in severe dehydrated pediatric patients with acute gastroenteritis. Patients and methods A cross-sectional study was conducted during the period study from August 2020 till March 2021, on 69 children, aged from 1 to 108 months, at the pediatric ICU) of Faculty of Medicine, Menoufia University, after obtaining consent from their parents and caregivers. Results NGAL level was highly significantly increased in the death group (1550.00 ± 57.74) than in the failure group (1425.00 ± 27.39), the injury group (929.76 ± 31.18), the risk group (866.36 ± 15.89), and the normal group (810.12 ± 37.42) (P < 0.001). Conclusion Urinary NGAL is a promising biomarker of AKI before a rise in serum creatinine) occurs. Severe dehydrated children have higher urinary NGAL concentrations compared with controls even in early stage with normal creatinine levels. So, urinary NGAL levels can be used for the early prediction of tubular renal impairment in children with severe dehydration better than creatinine.