الفهرس 
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Abstract
Acute kidney injury (AKI) is the most common complication of perinatal asphyxia that has been associated with increased morbidity and mortality in asphyxiated neonates. It has been shown that the current definition of AKI based on changes in serum creatinine level has variable limitations particularly in neonates. Hence, the introduction of new biomarkers such as serum and urinary NGAL, cystatin C, copeptin and kidney injury biomarker-1 has been widely studied to test their sensitivity and specificity in early prediction of acute kidney injury. Neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI; yet, there is a paucity of data about its use in neonates with perinatal asphyxia. Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe HIE. It was proposed that therapeutic hypothermia can reduce the incidence and severity of AKI among term neonates with perinatal asphyxia. The present study aimed to evaluate the renoprotective effect of selective head cooling in neonates with HIE. In addition, we aimed to determine the value of NGAL in prediction of AKI in those infants. The study recruited 30 neonates with HIE. They were equally distributed into one of the study groups: non-cooled group (n=15) or cooled group (n=15). All participants were subjected to careful history taking, thorough clinical examination and complete laboratory investigations including renal functions, blood gases analysis and serum NGAL. Basically, there were no statistically significant differences between the studied groups regarding important the demographic and perinatal data. In the current study, AKI was diagnosed in 8 patients (53.3 %) in the non-cooled group and in 6 patients (40.0 %) in the cooled group with a total of 14 patients (46.7 %) in the whole study Considering the other study outcomes, no statistically significant differences were found between the studied groups regarding mortality, length of hospital stay and duration of mechanical ventilation.Regression analysis for predictors of AKI in the present study recognized seizures at randomization, persistent pulmonary hypertension and length of hospital stay as significant predictors in univariate analysis. However, in multivariate analysis, only persistent pulmonary hypertension remained significant. Serum NGAL is a sensitive and specific parameter for early prediction of AKI. Continuing kidney injury may persist in asphyxiated newborn despite improvement in serum creatinine and UOP as evident by persistent elevation of serum NGAL.