الفهرس 
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Abstract
Perinatal asphyxia is the medical condition resulting from deprivation of oxygen (hypoxia) to a newborn infant long enough to cause apparent harm.
The aim of this work was to evaluate the value of serum NGAL measurement as an early predictor of acute kidney injury in asphyxiated neonates.
Our study was a case - control study, carried on 20 term newborns diagnosed as HIE. Cases group had mean G.A(37.9 ±1.1 )weeks and birth weight .3050±506.3 gm .while control group( 20 term healthy newborns) had mean G.A(38.1± 1.07) weeks and birth weight (3317.5±409.5) gm.
Perinatal asphyxia was diagnosed based on the presence of at least two of the following:
1. Profound metabolic or mixed acidemia (pH<7.00) in an umbilical artery blood sample with base deficit >10m mol/L.
2. Persistence of Apgar score of ≤ 3 and ≤ 5 at one and five minutes respectively.
3. Neonatal neurological sequelae (seizures, coma, hypotonia).
4. Multiple organs involvement (kidney, lungs, liver, heart, intestine).
Both groups were subjected to complete history taking, thorough clinical examination, laboratory investigations including CBC, CRP, BUN, Cr.
Serum samples were collected in the first 24hrs of life from cases and controls in order to detect serum NGAL levels by ELIZA.
In the present study, the median level of serum NGAL in control group was 39.75ng/ml with IQ range of 6.0-48.0 ng/ml
with no significant difference between males and females or between those delivered vaginally or by C.S.
Our study showed no significant correlation between NGAL level and between G.A, B.W, BUN, yet there was a significant positive correlation with serum Cr.
In our study, There was no statistical significant difference between cases and control groups as regards GA, BW, Sex, mode of delivery(P>0.05) yet, Apgar scores at 1, 5 and 10 minutes were significantly lower among asphyxiated groups compared to control group (P<0.001).
Our study showed that HB level and platelet count were significantly lower among asphyxiated neonates as compared to control group (P<0.05),whereas BUN and creatinine levels were significantly higher among cases compared to control group (P<0.001).
In our study, we demonstrated highly significant increase in serum NGAL level in cases group compared with control group.
There was highly significant correlation between serum NGAL levels in cases and grading of HIE (p<0.001), whereas there was no correlation between NGAL and Apgar score. (p>0.05)
Also, serum NGAL level was significantly higher in hypoxic fullterm neonates who developed ARF compared with those who did not develop ARF (p<0.001).
In our study, serum NGAL level was significantly higher in ventilated than non ventilated cases, and in neonates with seizures than those without seizures.
Also, serum NGAL level was significantly higher in non-survivors than survivors (P<0.05) whereas there was no significant difference between CRP positive neonates and CRP negative neonates (P>0.05).
Regarding ROC curve our study revealed that NGAL can detect ARF at cutoff point of 165 ng/ml with sensitivity of 86% specificity of 92% PPV 86% NPV 92% .