The Diagnostic Value of Angiotensin, γ-GT, Blood Lactate, and Renal Resistance Index Combined Detection in Acute Kidney Injury After Neonatal Asphyxia
Combined Angiotensin, γ-GT, Lactate, and RRI in Neonatal Post-Asphyxia AKI
Abstract
Background: To investigate the diagnostic value of angiotensin (Ang), gamma-glutamyltransferase (γ-GT), blood lactic acid and renal resistive index (RRI) for acute kidney injury (AKI) after neonatal asphyxia.
Methods: A total of 120 asphyxiated neonates admitted to the hospital from May 2021 to April 2024 were retrospectively selected. According to whether AKI occurred after asphyxia, the neonates were divided into AKI group and non-AKI group. The occurrence of AKI in neonates with different degrees of asphyxia was analyzed. Plasma Ang-I and Ang-II levels and urine γ-GT level were compared between the AKI group and the non-AKI group. The blood gas analyzer was used to determine blood lactic acid levels and color Doppler ultrasound was used to evaluate RRI. The correlation between blood Ang, urine γ-GT, blood lactic acid, RRI and serum creatinine (Scr) and blood urea nitrogen (BUN) was discussed. Multivariate logistic regression model was used to identify factors influencing the occurrence of AKI after neonatal asphyxia. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of relevant indicators for AKI after neonatal asphyxia.
Results: Among the 120 asphyxiated neonates, the incidence of AKI was 39.17% (47/120). The incidence of AKI was significantly higher neonates with severe asphyxia than in those with mild asphyxia (P<0.05). Scr, BUN, Ang-II, urine γ-GT, blood lactic acid and RRI in the AKI group were higher than those in the non-AKI group (P<0.05), but there was no significant difference in Ang-I level (P>0.05). The levels of Ang-II, blood lactic acid and RRI were positively correlated with Scr and BUN in asphyxiated neonates (P<0.05). Logistic regression analysis showed that Ang-II, urine γ-GT, blood lactic acid, and RRI were independent risk factors for AKI after neonatal asphyxia (P<0.05). ROC curve analysis showed that the areas under the curve of Ang-II, urine γ-GT, blood lactic acid, and RRI for diagnosing AKI after neonatal asphyxia were 0.812, 0.693, 0.811, and 0.733, with no significant difference (P>0.05). The AUC of joint diagnosis using above indexes was 0.941, which was greater than that of each index (P<0.05).
Conclusion: Ang-II, urine γ-GT and blood lactic acid combined with RRI demonstrates certain diagnostic value for AKI after neonatal asphyxia.
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