Early Detection of Neonatal Kidney Disease in High Risk Neonates Admitted to Neonatal Intensive Care Unit

3 Abstract: This work conducted to study the pattern of different kidney disorders in the NICU, Cairo University during a period of one year. Also, to investigate the role of cystatin C and B2 microglobulin as biomarker in the diagnosis and monitoring of renal diseases. This study included 80 neonates with different patterns of renal disorder. Inclusion criteria were: acute renal injury, proteinuria, hematuria and UTI. The neonates were subjected to history taking and clinical examination. Laboratory investigations will be monitored at day 0, day 4 and on discharge by: CBC, serum sodium, potassium, phosphorus, BUN, creatinine, serum cystatine C and B2 microglobulin. Results: total number of admitted cases was 1143 neonates, signs or laboratory findings suggestive of kidney involvement were present in 6.8% of them, AKI represent 49.8% cases. The commonest cause of AKI was sepsis (72.5%). Initial serum cystatine C and B2 microglobulin revealed no difference while at day 4 and on discharge there was significant difference between AKI and non AKI group (P<0.05). On admission serum cystatine C and creatinine revealed no difference while the difference at day 4 was significantly higher in the AKI group, on discharge there was no difference. Conclusion: Although renal insult in babies admitted to NICU had a low prevalence it contributed to mortality of 30%, AKI was the most common cause of kidney affection. Serum cystatine-C and B2 microglobulin may be considered as sensitive predictive parameters for reduced glomerular filteration rate. It is of value for the laboratory diagnosis of AKI.