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Urine neutrophil gelatinase-associated lipocalin to predict acute kidney injury in preterm neonates. A pilot study

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Abstract

Background

The efficacy of urine neutrophil gelatinase-associated lipocalin (uNGAL) as an early acute kidney injury (AKI) biomarker in preterm neonates was evaluated.

Methods

Thirty-five preterm neonates were prospectively evaluated for serum creatinine (sCre)-documented AKI during the first 14 days of life. Urine samples were collected daily throughout the study period. Of the neonates evaluated, we analyzed 11 who developed AKI (cases) and an equal number of neonates without AKI (controls) matched for gestational and postnatal age (case–control study). uNGAL was measured on the day of AKI occurrence (day 0) and on the 2 days preceding the event (day −1 and day −2, respectively) using an enzyme-linked immunosorbent assay.

Results

Cases had significantly higher sCre levels than controls on day 0 (1.21 ± 0.48 vs. 0.83 ± 0.16 mg/dL, p = 0.031) but not on days −1 and −2. Similarly, uNGAL levels (ng/mL) were significantly higher in cases than in controls only on day 0 (19.1 ± 3.5 vs. 13.3 ± 7.3, p = 0.017) and not on days −1 (18.8 ± 3.4 vs. 16.3 ± 5.9, p = 0.118) and −2 (19.3 ± 1.8 vs. 19.4 ± 0.8, p = 0.979). The receiver operating characteristic curve analysis showed no significant ability of uNGAL to predict AKI on days −2 and −1.

Conclusions

In this pilot study in preterm neonates, although uNGAL detected sCre-based AKI upon its documentation, it failed to predict its development 1–2 days earlier.

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References

  1. Cataldi L, Leone R, Moretti U, De Mitri B, Fanos V, Ruggeri L, Sabatino G, Torcasio F, Zanardo V, Attardo G, Riccobene F, Martano C, Benini D, Cuzzolin L (2005) Potential risk factors for the development of acute renal failure in preterm newborn infants: a case–control study. Arch Dis Child Fetal Neonatal Ed 90:F514–F519

    Article  CAS  PubMed  Google Scholar 

  2. Koralkar R, Ambalavanan N, Levitan EB, McGwin G, Goldstein S, Askenazi D (2011) Acute kidney injury reduces survival in very low birth weight infants. Pediatr Res 69:354–358

    Article  PubMed  Google Scholar 

  3. Viswanathan S, Manyam B, Azhibekov T, Mhanna MJ (2012) Risk factors associated with acute kidney injury in extremely low birth weight (ELBW) infants. Pediatr Nephrol 27:303–311

    Article  PubMed  Google Scholar 

  4. Walker MW, Clark RH, Spitzer AR (2011) Elevation in plasma creatinine and renal failure in premature neonates without major anomalies: terminology, occurrence and factors associated with increased risk. J Perinatol 31:199–205

    Article  CAS  PubMed  Google Scholar 

  5. Jetton JG, Askenazi DJ (2012) Update on acute kidney injury in the neonate. Curr Opin Pediatr 24:191–196

    Article  CAS  PubMed  Google Scholar 

  6. Mishra J, Ma Q, Prada A, Mitsnefes M, Zahedi K, Yang J, Barasch J, Devarajan P (2003) Identification of neutrophil gelatinase-associated lipocalin as a novel early urinary biomarker for ischemic renal injury. J Am Soc Nephrol 14:2534–2543

    Article  CAS  PubMed  Google Scholar 

  7. Mishra J, Dent C, Tarabishi R, Mitsnefes MM, Ma Q, Kelly C, Ruff SM, Zahedi K, Shao M, Bean J, Mori K, Barasch J, Devarajan P (2005) Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet 365:1231–1238

    Article  CAS  PubMed  Google Scholar 

  8. Krawczeski CD, Woo JG, Wang Y, Bennett MR, Ma Q, Devarajan P (2011) Neutrophil gelatinase-associated lipocalin concentrations predict development of acute kidney injury in neonates and children after cardiopulmonary bypass. J Pediatr 158:1009–1015.e1

    Article  CAS  PubMed  Google Scholar 

  9. Zappitelli M, Washburn KK, Arikan AA, Loftis L, Ma Q, Devarajan P, Parikh CR, Goldstein SL (2007) Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study. Crit Care 11:R84

    Article  PubMed  Google Scholar 

  10. de Geus HR, Bakker J, Lesaffre EM, le Noble JL (2011) Neutrophil gelatinase-associated lipocalin at ICU admission predicts for acute kidney injury in adult patients. Am J Respir Crit Care Med 183:907–914

    Article  PubMed  Google Scholar 

  11. Mårtensson J, Bell M, Oldner A, Xu S, Venge P, Martling CR (2010) Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury. Intensive Care Med 36:1333–1340

    Article  PubMed  Google Scholar 

  12. Malyszko J, Bachorzewska-Gajewska H, Poniatowski B, Malyszko JS, Dobrzycki S (2009) Urinary and serum biomarkers after cardiac catheterization in diabetic patients with stable angina and without severe chronic kidney disease. Ren Fail 31:910–919

    Article  CAS  PubMed  Google Scholar 

  13. Wagener G, Minhaz M, Mattis FA, Kim M, Emond JC, Lee HT (2011) Urinary neutrophil gelatinase-associated lipocalin as a marker of acute kidney injury after orthotopic liver transplantation. Nephrol Dial Transplant 26:1717–1723

    Article  CAS  PubMed  Google Scholar 

  14. Askenazi DJ, Montesanti A, Hunley H, Koralkar R, Pawar P, Shuaib F, Liwo A, Devarajan P, Ambalavanan N (2011) Urine biomarkers predict acute kidney injury and mortality in very low birth weight infants. J Pediatr 159:907–912.e1

    Article  CAS  PubMed  Google Scholar 

  15. Sarafidis K, Tsepkentzi E, Agakidou E, Diamanti E, Taparkou A, Soubasi V, Papachristou F, Drossou V (2012) Serum and urine acute kidney injury biomarkers in asphyxiated neonates. Pediatr Nephrol 27:1575–1582

    Article  PubMed  Google Scholar 

  16. Askenazi DJ, Koralkar R, Levitan EB, Goldstein SL, Devarajan P, Khandrika S, Mehta RL, Ambalavanan N (2011) Baseline values of candidate urine acute kidney injury biomarkers vary by gestational age in premature infants. Pediatr Res 70:302–306

    Article  PubMed Central  PubMed  Google Scholar 

  17. Huynh TK, Bateman DA, Parravicini E, Lorenz JM, Nemerofsky SL, Sise ME, Bowman TM, Polesana E, Barasch JM (2009) Reference values of urinary neutrophil gelatinase-associated lipocalin in very low birth weight infants. Pediatr Res 66:528–532

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. de Graaf MA, Jager KJ, Zoccali C, Dekker FW (2011) Matching, an appealing method to avoid confounding? Nephron Clin Pract 118:315–318

    Article  Google Scholar 

  19. Conway A, Rolley JX, Fulbrook P, Page K, Thompson DR (2013) Improving statistical analysis of matched case–control studies. Res Nurs Health 36:320–324

    Article  PubMed  Google Scholar 

  20. Devarajan P (2011) Biomarkers for the early detection of acute kidney injury. Curr Opin Pediatr 23:194–200

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Wagener G, Jan M, Kim M, Mori K, Barasch JM, Sladen RN, Lee HT (2006) Association between increases in urinary neutrophil gelatinase-associated lipocalin and acute renal dysfunction after adult cardiac surgery. Anesthesiology 105:485–491

    Article  CAS  PubMed  Google Scholar 

  22. Fuchs TC, Frick K, Emde B, Czasch S, von Landenberg F, Hewitt P (2012) Evaluation of novel acute urinary rat kidney toxicity biomarker for subacute toxicity studies in preclinical trials. Toxicol Pathol 40:1031–1048

    Article  PubMed  Google Scholar 

  23. Lavery AP, Meinzen-Derr JK, Anderson E, Ma Q, Bennett MR, Devarajan P, Schibler KR (2008) Urinary NGAL in premature infants. Pediatr Res 64:423–428

    Article  CAS  PubMed  Google Scholar 

  24. Legrand M, Collet C, Gayat E, Henao J, Giraudeaux V, Mateo J, Launay JM, Payen D (2013) Accuracy of urine NGAL commercial assays in critically ill patients. Intensive Care Med 39:541–542

    Article  PubMed  Google Scholar 

  25. Alabbas A, Campbell A, Skippen P, Human D, Matsell D, Mammen C (2013) Epidemiology of cardiac surgery-associated acute kidney injury in neonates: a retrospective study. Pediatr Nephrol 28:1127–1134

    Article  PubMed  Google Scholar 

  26. Vanmassenhove J, Vanholder R, Nagler E, Van Biesen W (2013) Urinary and serum biomarkers for the diagnosis of acute kidney injury: an in-depth review of the literature. Nephrol Dial Transplant 28:254–273

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. 1st Department of Neonatology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Kosmas Sarafidis, Eleni Tsepkentzi, Elisavet Diamanti, Eleni Agakidou, Vasiliki Soubasi & Vasiliki Drossou

  2. 1st Department of Pediatrics, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Anna Taparkou & Fotios Papachristou

  3. 1st Department of Neonatology, Hippokrateio General Hospital, Kostantinoupoleos 49, 54641, Thessaloniki, Greece

    Kosmas Sarafidis

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  1. Kosmas Sarafidis
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  2. Eleni Tsepkentzi
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  3. Elisavet Diamanti
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  4. Eleni Agakidou
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  8. Vasiliki Drossou
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Correspondence to Kosmas Sarafidis.

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Sarafidis, K., Tsepkentzi, E., Diamanti, E. et al. Urine neutrophil gelatinase-associated lipocalin to predict acute kidney injury in preterm neonates. A pilot study. Pediatr Nephrol 29, 305–310 (2014). https://doi.org/10.1007/s00467-013-2613-6

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  • DOI: https://doi.org/10.1007/s00467-013-2613-6

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