Background:Acute heart failure (AHF) is frequently associated with worsening renal function in pediatric patients. Neutrophil gelatinase-associated lipocalin (NGAL) serves as an early marker for acute kidney injury.
Objective:To improve survival and healthy outcome of infants with acute congestive heart failure through detection of the role of U-NGAL in predicting patient outcome.
Methods:A prospective follow up study of 30 patients presented with acute congestive heart failure from December 2018 to May 2019 in pediatrics Department, Zagazig University Hospitals were recruited. Patients were divided into two groups: group (A): patients with AKI and group (B): patients without AKI. Echocardiographic examination was performed on admission. Urea, serum creatinine, estimated glomerular filtration rate (eGFR) and Urinary NGAL were measured at 1st day of admission, 3rd day and at the end of recompensation therapy.
Results:Fifteen (50%) patients developed AKI within the follow-up period. At 1st day, 3rd day and end day of recompensation therapy, urinary NGAL level was significantly elevated in infant who developed AKI. For prediction of AKI, admission urinary NGAL level >152.37 ng/ml had sensitivity and specificity of 100% and 93.3%, respectively. The area under the receiver–operator curve was 0.97.At a cut off value > 173.2 ng/ml,the sensitivity was 100% and the specificity was 75.29% to detect mortality and adverse outcome among studied patients.
Conclusion: Admission urinary NGAL level can predict AKI and in-hospital outcome (mortality and adverse events) in infants hospitalized for AHF