Comparative Efficacy of Serum Creatinine and Microalbuminuria in Detecting Early Renal Injury in Asphyxiated Babies in Calabar, Nigeria


  • Sunday O. Ochigbo Department of Pediatrics, University of Calabar,
  • Udo J. Jacob Department of Pediatrics, University of Calabar,
  • Anthony C. Nlemadim Department of Pediatrics, University of Calabar Teaching Hospital,
  • Olaniyo O. Kudirat Department of Pediatrics, University of Calabar Teaching Hospital,



Micral test strip, Birth Asphyxia, Acute Kidney Injury, APGAR, Newborn.


Background: Microalbuminuria and serum creatinine are markers of acute kidney injury. Birth asphyxia is responsible for 50% of all newborn deaths and acute non-oliguric kidney injury is one of such complications. This study was undertaken to determine the efficacy of serum creatinine and microalbuminuria for the detection of early renal lesion in severely asphyxiated babies in Calabar, Nigeria.

Materials and Method: This prospective cross-sectional investigational study was undertaken among severely asphyxiated babies admitted into the newborn units of the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Standard method for blood collection and determination of urea, electrolytes were used. Micral-test strips were used on samples negative only for albumin after using urine dipstick. Color comparison was done with the standardized color scale on test strip container after 5 minutes.

Results: Fifty term newborn babies were enrolled, their serum electrolytes, creatinine and creatinine clearance were essentially normal. Six (12%) babies had positive microalbuminuria, while 44(88%) had negative microalbuminuria with specificity and negative predictive values of 100% and 88% respectively.

Conclusion: Microalbuminuria was not useful for early detection of acute renal failure in babies with severe birth asphyxia, but further studies are recommended.


[1] Gerstein HC, Mann JF, Yi Q, et al. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA 2001; 286: 421-6.
[2] Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002; 39: 930-6.
[3] Ostermann M, Chang RW. Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med 2007; 35: 1837-43.
[4] Tseng CL, Kern EF, Miller DR, et al. Survival benefit of nephrologic care in patients with diabetes mellitus and chronic kidney disease. Arch Intern Med 2008; 168: 55-62.
[5] Guidelines LMP. Microalbuminuria. [September 2, 2012]; Available from: 2009/09/microalb.pdf.
[6] Askenazi DJ, Ambalavanan N, Goldstein SL. Acute kidney injury in critically ill newborns: what do we know? What do we need to learn? Pediatr Nephrol 2009; 24: 265-74.
[7] Udo JJ, Ntia HU, Anah MU, Eyong KI, Ewa AU, Etuk IS. HIV seroprevalence in children whose mothers were seronegative at antenatal care booking in an immunization centre in Calabar, Nigeria. Pediatr Infect Dis J 2013; 8: 83-6.
[8] Schwartz GJ, Furth SL. Glomerular filtration rate measurement and estimation in chronic kidney disease. Pediatr Nephrol 2007; 22: 1839-48.
[9] Roche diagnostics Quebec, Canada. 201 boul Armand-Frappier Laval, QC H7V 4A2,(450) 686-7050 Fax:(450) 686-7012.
[10] Lawn J, Shibuya K, Stein C. No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths. Bull World Health Organ 2005; 83: 409-17.
[11] Gupta BD, Sharma P, Bagla J, Parakh M, Soni JP. Renal failure in asphyxiated neonates. Indian Pediatr 2005; 42: 928-34.
[12] Andreoli SP. Acute renal failure in the newborn. Semin Perinatol 2004; 8: 112-23.
[13] Cuzzolin L, Fanos V, Pinna B, et al. Postnatal renal function in preterm newborns: a role of diseases, drugs and therapeutic interventions. Pediatr Nephrol 2006; 21: 931-8.
[14] Byung Ok, Sang TL, Sochung C, Kyo S K. Microalbuminuria in normal Korean children. Yonsei Med J 2011; 52: 476-81.
[15] Gould MM, Mohamed-Ali V, Goubet SA, Yudkin JS, Haines AP. Microalbuminuria: associations with height and sex in non-diabetic subjects. BMJ 1993 23; 306: 240-2.
[16] Basu P, Som S, Das H, Choudhuri N. Electrolyte status in birth asphyxia. Indian J Pediatr 2010; 77: 259-62.
[17] Aggarwal A, Kumar P, Chowdhary G, Majumdar S, Narang A. Evaluation of renal functions in asphyxiated newborns. J Trop Pediatr 2005; 51: 295-9.
[18] Abhulimhen–Iyoha IB, Ibadin OM, Ofovwe EG. Comparative usefulness of serum creatinine and microalbuminuria in detecting early renal changes in children with sickle cell anaemia in Benin city. Nig J Paediatr 2009; 36: 1-8.
[19] Eke CB. Microalbuminuria in children with Sickle cell anaemia seen at University of Nigeria Enugu Teaching Hospital; FWACP April 2010.
[20] Solarin AU, Njokanma FO, Kehinde O. Prevalence and clinical correlates of microalbuminuria among children with sickle cell anaemia attending Lagos state University teaching hospital, Ikeja. Afr J Paed Nephrol 2014; 1: 37-45.






General Articles