***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction Acute kidney injury ( AKI ) is common in neonatal intensive care units ( NICU ) . In recent years , every effort is made for early detection of AKI . Our hypothesis was that serum neutrophil gelatinase-associated lipocalin ( sNGAL ) may be a reliable screening test for early diagnosis of AKI in premature neonates after perinatal asphyxia . Therefore , our aim was to assess the diagnostic accuracy of sNGAL for AKI in premature asphyxiated neonates . Material s and methods AKI was defined in the third day of life ( DOL 3 ) as a  serum creatinine ( sCr ) increase ≥ 26.5 μmol/L from baseline ( the lowest previous sCr ) . According to the increase of sCr , AKI patients were divided in AKIN1 ( sCr increase up to 1.9 baseline ) and AKIN2 ( sCr increase from 2.0 to 2.9 baseline ) . sNGAL levels were measured on DOL 1 , 3 and 7 . Results AKI was diagnosed in 73 ( 0.676 ) of 108 enrolled premature asphyxiated neonates . Sixty one patients ( 0.836 ) were classified in AKIN1 and 12 patients ( 0.164 ) in AKIN2 . sNGAL reached the maximal concentrations on DOL 1 within 4 hours after admission to NICU , being higher in AKI compared with no-AKI group ( 160.8 ± 113.1 vs. 87.1 ± 81.6 ; P < 0.001 ) as well as in AKIN2 compared with AKIN1 group ( 222.8 ± 112.9 vs. 147.8 ± 109.9 ; P < 0.001 ) . The best areas under the receiver operating characteristic curves ( AUC ) for prediction of AKI were 0.72 [ 95 % ( 0.62 - 0.80 ) P < 0.001 ] on DOL1 at 2h and 0.72 [ 95 % ( 0.63 - 0.80 ) P < 0.001 ] at 4th hour after admission respectively . The corresponding sNGAL cutoff concentrations were 84.87 ng/mL ( sensitivity 69.0 % and specificity 71.9 % ) and 89.43 ng/mL ( sensitivity 65.7 % and specificity 74.3 % ) . Conclusions In premature asphyxiated neonates sNGAL measured within the first 4 hours of DOL 1 is predictive of the occurrence and severity of AKI . Therefore , plasma levels of NGAL may be used for early diagnosis of AKI in these patients Background . The kidney is the most damaged organ in asphyxiated full-term infants . Experiments in rabbits and rats have shown that renal adenosine acts as a vasoconstrictive metabolite in the kidney after hypoxemia and /or ischemia , contributing to the fall in glomerular filtration rate ( GFR ) and filtration fraction . Vasoconstriction produced by adenosine can be inhibited by the nonspecific adenosine receptor antagonist , theophylline . Gouyon and Guignard performed studies in newborn and adult rabbits subjected to normocapnic hypoxemia . Their results clearly showed that the hypoxemia-induced drop in GFR could be avoided by the administration of low doses of theophylline . Objective . This study was design ed to determine whether theophylline could prevent and /or ameliorate renal dysfunction in term neonates with perinatal asphyxia . Setting . Buenos Aires , Argentina . Study Design . We r and omized 51 severe asphyxiated term infants to receive intravenously a single dose of either theophylline ( 8 mg/kg ; study group : n = 24 ) or placebo ( control group : n = 27 ) during the first 60 minutes of life . The 24-hour fluid intake and the urine volumes formed were recorded during the first 5 days of life . Daily volume balances ( water output/input ratio and weights ) were determined . Severe renal dysfunction was defined as serum creatinine elevated above 1.50 mg/dL , for at least 2 consecutive days after a fluid challenge , or rising levels of serum creatinine ( .3 mg/dL/day ) . The GFR was estimated during the second to third days of life by endogenous creatinine clearance ( mL/minute/1.73 m2 ) and using Schwartz 's formula : GFR ( mL/minute/1.73 m2 ) = .45 × length (cm)/plasma creatinine ( mg/100 mL ) during the first 5 days of life . Tubular performance was assessed as the concentration of β2-microglobulin ( β2 M ) determined by enzyme immunoassay , on the first voided urine 12 hours after theophylline administration . The statistical analysis for the evaluation of the differences between the groups was performed with Student'st and χ2 tests as appropriate . Results . During the first day of life , the 24-hour fluid balance was significantly more positive in the infants receiving placebo compared with the infants receiving theophyline . Over the next few days , the change in fluid balance favored the theophyline group . Significantly higher mean plasma values were recorded in the placebo group from the second to the fifth days of life . Severe renal dysfunction was present in 4 of 24 ( 17 % ) infants of the theophylline group and in 15 of 27 ( 55 % ) infants of the control group ( relative risk : .30 ; 95 % confidence interval : .12–.78 ) . Mean endogenous creatinine clearance of the theophylline group was significantly increased compared with the creatinine clearance in infants receiving placebo ( 21.84 ± 7.96 vs 6.42 ± 4.16 ) . The GFR ( estimated by Schwartz 's formula ) was markedly decreased in the placebo group . Urinary β2 M concentrations were significantly reduced in the theophylline group ( 5.01 ± 2.3 mg/L vs 11.5 ± 7.1 mg/L ) . Moreover , 9 ( 33 % ) patients of the theophylline group versus 20 ( 63 % ) infants of the control group had urinary β2 M above the normal limit ( < .018 ) . There was no difference in the severity of the asphyxia between infants belonging to the theophylline and control groups in regards of Portman 's score . Except for renal involvement , a similar frequency of multiorganic dysfunction , including neurologic impairment , was observed in both groups . The theophylline group achieved an average serum level of 12.7 μg/mL ( range : 7.5–18.9 μg/mL ) at 36 to 48 hours of live versus traces ( an average serum level of .87 μg/mg ) in the placebo group . Conclusions . Our data suggest that prophylactic theophylline , given early after birth , has beneficial effects on reducing the renal dysfunction in asphyxiated full-term infants . A single dose of 8 mg/kg of theophylline within the first postnatal hour in term neonates with severe perinatal asphyxia results in a significant decrease in serum creatine and urinary β2 M , together with a significant increase in the creatine clearance . The potential clinical relevance of the data would be the avoidance of the contributory role of hypoxemia in the development of acute renal failure . Additional studies will be necessary before the use of theophylline in asphyxiated newborns can be considered for clinical practice Abstract Objective : The objective of this study is to evaluate whether therapeutic hypothermia reduces the incidence of acute kidney injury ( AKI ) among term neonates perinatal asphyxia . Methods : This r and omized controlled trial conducted in a tertiary care teaching hospital , south India included 120 term neonates with perinatal asphyxia who were r and omized to receive either therapeutic hypothermia or st and ard supportive care .  Renal parameters of neonates in both the groups were monitored and AKI was ascertained as per Acute Kidney Injury Network criteria . Results : The incidence of AKI was less in therapeutic hypothermia group compared to st and ard treatment group ( 32 % versus 60 % , p < 0.05 ) . The incidence of Stages 1 , 2 , and 3 AKI was 22 % , 5 % , and 5 % in therapeutic hypothermia group compared with 52 % , 5 % , and 3 % , respectively , in the st and ard treatment group . The mortality was less in therapeutic hypothermia group compared with the st and ard treatment group ( 26 % versus 50 % , p < 0.05 ) . Conclusion : Therapeutic hypothermia reduces the incidence and severity of AKI among term neonates with perinatal asphyxia OBJECTIVES Considering the relation between prematurity and asphyxia and also renal failure in neonates , the aim of this study was to determine the effect of aminophyllinein  urine and serum indices of renal failure and consequently its prevention , in Premature Infants with asphyxia in Esfahan-lran . METHODS In this descriptive clinical trial study , 22 preterm neonates diagnosed with perinatal asphyxia in neonatal ward of Shahid Beheshti hospital , during 2009.The participants were r and omized in two intervention and placebo groups . They r and omized to receive a single dose of aminophyiline ( 5 mg/kg ) or placebo of 5 % dextrose water for injection ( 5 cc/kg ) during the first hour of life . Renal function was assessed by GFR , beta2-microglobulin ( beta2 M ) , N-acetyl-glucosaminidase ( NAG ) serum creatinine and electrolytes level measurement , during the 1st , 4th and 7th day of life , in two studied groups . The results compare between the two groups before and after intervention . RESULTS Mean of urine output , was significantly higher in neonates who received aminophylline ( P < 0.05).Mean of 132 M and NAG 24 hours after intervention was not significant in the two groups of asphyxiated preterm neonates ( P > 0.05).GFR was significantly higher in neonates who received aminophylline on 4th day of life ( P < 0.05 ) and it had trend to be significantly high on 7th day ( P = 0.05 ) and was not significantly high on 1st day ( P > 0.05 ) comparing with control group . The most common pathophysiology of renal failure was prerenal . CONCLUSION Aminophylline could prevent renal dysfunction in preterm neonates with asphyxia . Neonates who received aminophylin on the first day of life indicated a significant improvement in GFR and urine output INTRODUCTION Recent reports have revealed increased concentration of neutrophil gelatinase-associated lipocalin ( NGAL ) in cardiovascular diseases and after episodes of hypoxia . We hypothesized that elevated plasma NGAL levels could be a result of vascular endothelial injury due to perinatal asphyxia . MATERIAL S AND METHODS Ninety-three newborns with a gestational age > or = 37 weeks , of which 32 newborns were asphyxiated ( study group ) , and 61 were healthy children ( control group ) , were enrolled in the study  Serum NGAL , lactate and creatinine concentrations , acid-base balance , neutrophil and white blood cell count were measured in the umbilical cord blood . RESULTS Asphyxiated newborns had a significantly lower pH value ( 7.0 vs. 7.3 , p < 0.001 ) , lower HCO3 ( 15.8 mmol/L vs. 23.2 mmol/L ; p < 0.001 ) and higher lactate concentrations ( 7.5 mmol/L vs. 2.3 mmol/L ; p < 0.001 ) , as compared to controls . Neutrophil count ( 10.3 x 109/L vs. 6.5 x 109/L ; p = 0.02 ) and NGAL concentration ( 122.5 ng/mL vs. 24.3 ng/ mL p < 0.001 ) were elevated in asphyxiated newborns as compared to healthy children . CONCLUSIONS The measurement of  NGAL  in the umbilical blood can be a valuable biomarker of perinatal asphyxia in neonates Background Acute kidney injury ( AKI ) is the most common complication of perinatal asphyxia . Recent research indicates that urine neutrophil gelatinase-associated lipocalin ( NGAL ) is an early marker for AKI ; yet , there is a paucity of data about its use in term neonates with perinatal asphyxia . Methods A prospect i ve cohort study was conducted on 108 term babies in the new-born unit of Pumwani Maternity Hospital and Kenyatta National Hospital .  Urine NGAL and serum creatinine  were measured in 108 term asphyxiated neonates on days 1 and 3 of life . Results One-hundred and eight patients were recruited ( male : female 1.4:1 ) . At a cut-off of 250 ng/ml , urine NGAL had an acceptable discriminative capability of predicting AKI ( 
    Output:
    
Conclusion : Serum and urinary NGAL represent c and i date biomarkers with high performance in the prediction of acute kidney injury in newborns with perinatal asphyxia .
What is Known:• Acute kidney injury is a major cause of morbidity and mortality in perinatal asphyxia.• Current markers are insufficient in predicting post-asphyxial acute kidney injury .
What is New:• Area under the curve for serum and urinary neutrophil gelatinase-associated lipocalin is 0.818 and 0.899 , respectively.• Neutrophil gelatinase-associated lipocalin is a useful marker for detecting asphyxiated neonates at risk of developing acute kidney injury