Urine biomarkers predict acute kidney injury in newborns.

Academic Article

Abstract

  • OBJECTIVE: To identify urine biomarkers predictive of acute kidney injury (AKI) in infants admitted to level 2 and 3 neonatal intensive care units with birth weight >2000 g and 5-minute Apgar score ≤ 7. STUDY DESIGN: A nested case-control study was performed comparing 8 candidate urine AKI biomarkers in infants with AKI (defined as a rise in serum creatinine of at least 0.3 mg/dL or a serum creatinine elevation ≥ 1.7 mg/dL persisting for 3 days) and 24 infants from the described cohort without AKI. Urine was analyzed for neutrophil gelatinase-associated lipocalin, osteopontin, cystatin C, albumin, β(2) microglobulin, epithelial growth factor, uromodulin (UMOD), and kidney injury molecule 1. RESULTS: Compared with the infants without AKI, those with AKI had higher levels of urine cystatin C (1123 pg/mL [95% CI, 272-4635 pg/mL] vs 90 pg/mL [95% CI, 39-205 pg/mL]; P < .004; area under the receiver operating characteristic curve [AUC] = 0.82), lower levels of UMOD (11.0 pg/mL [95% CI, 5.7-21.4 pg/mL] vs 26.2 pg/mL [95% CI, 17.4-39.4 pg/mL]; P < .03; AUC = 0.77), and lower levels of epithelial growth factor (6.7 pg/mL [95% CI, 4.0-11.3 pg/mL] vs 17.4 pg/mL [95% CI, 12.7-23.8 pg/mL; P = .003; AUC = 0.82). Although the differences were not statistically significant, levels of urine neutrophil-associated gelatinase lipocalin, kidney injury molecule 1, and osteopontin trended higher in infants with AKI. CONCLUSION: Urinary biomarkers can predict AKI in neonates admitted to level 2 and 3 neonatal intensive care units.
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    Keywords

  • Acute Kidney Injury, Acute-Phase Proteins, Biomarkers, Case-Control Studies, Creatinine, Cystatin C, Epidermal Growth Factor, Female, Hepatitis A Virus Cellular Receptor 1, Humans, Infant, Newborn, Lipocalin-2, Lipocalins, Male, Membrane Glycoproteins, Osteopontin, Predictive Value of Tests, Proto-Oncogene Proteins, Receptors, Virus, Uromodulin
  • Digital Object Identifier (doi)

    Author List

  • Askenazi DJ; Koralkar R; Hundley HE; Montesanti A; Parwar P; Sonjara S; Ambalavanan N
  • Start Page

  • 270
  • End Page

  • 5.e1
  • Volume

  • 161
  • Issue

  • 2