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DOI: 10.1055/s-0032-1329692
Urinary Neutrophil Gelatinase-Associated Lipocalin in Septic Preterm Babies: A Preliminary Study
Publication History
05 July 2012
23 August 2012
Publication Date:
31 December 2012 (online)
Abstract
Objective This study was conducted to evaluate the predictive value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for acute kidney injury (AKI) among septic preterm infants.
Methods Twenty-six very low-birth-weight (VLBW) babies were separated into three groups: group I, healthy preterms; group II, preterms with sepsis but without AKI; group III, preterms with sepsis and AKI. Demographic, clinical, and laboratory data of the babies were recorded. uNGAL and creatinine values were obtained on days 1, 3, and 7 of life.
Results uNGAL levels differed statistically among three groups for all 3 days. Levels in group I (days 1, 3, and 7) were significant lower than levels in both groups II and III [median (interquartile range): 4.5 (10.8) µ/L, 8.7 (18.5) µ/L, and 4.3 (1.1) µ/L, respectively]. In group III, uNGAL levels on days 1 and 3 were significantly higher than levels in group II (p = 0.001, 0.016, respectively).
Conclusion First-day uNGAL levels were higher in VLBW preterm infants who later developed sepsis; whether the baby had AKI or not; but uNGAL levels were higher in septic babies with AKI compared with the infants without AKI. uNGAL is a promising early biomarker of AKI in VLBW infants with sepsis.
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References
- 1 Tóth-Heyn P, Drukker A, Guignard JP. The stressed neonatal kidney: from pathophysiology to clinical management of neonatal vasomotor nephropathy. Pediatr Nephrol 2000; 14: 227-239
- 2 Guignard JP. The adverse renal effects of prostaglandin-synthesis inhibitors in the newborn rabbit. Semin Perinatol 2002; 26: 398-405
- 3 Ho E, Fard A, Maisel A. Evolving use of biomarkers for kidney injury in acute care settings. Curr Opin Crit Care 2010; 16: 399-407
- 4 Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 2005; 16: 3365-3370
- 5 Bellomo R, Kellum JA, Ronco C. Defining acute renal failure: physiological principles. Intensive Care Med 2004; 30: 33-37
- 6 Cruz DN, de Cal M, Garzotto F , et al. Plasma neutrophil gelatinase-associated lipocalin is an early biomarker for acute kidney injury in an adult ICU population. Intensive Care Med 2010; 36: 444-451
- 7 Nickolas TL, O'Rourke MJ, Yang J , et al. Sensitivity and specificity of a single emergency department measurement of urinary neutrophil gelatinase-associated lipocalin for diagnosing acute kidney injury. Ann Intern Med 2008; 148: 810-819
- 8 Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A. NGAL Meta-analysis Investigator Group. Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis 2009; 54: 1012-1024
- 9 Mårtensson J, Bell M, Oldner A, Xu S, Venge P, Martling CR. Neutrophil gelatinase-associated lipocalin in adult septic patients with and without acute kidney injury. Intensive Care Med 2010; 36: 1333-1340
- 10 Bagshaw SM, Bennett M, Haase M , et al. Plasma and urine neutrophil gelatinase-associated lipocalin in septic versus non-septic acute kidney injury in critical illness. Intensive Care Med 2010; 36: 452-461
- 11 Avery GB, MacDonald MG, Seshia MMK, Mullet MD. Avery's Neonatology: Pathophysiology and Management of the Newborn. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2005: 560
- 12 Lavery AP, Meinzen-Derr JK, Anderson E , et al. Urinary NGAL in premature infants. Pediatr Res 2008; 64: 423-428
- 13 Huynh TK, Bateman DA, Parravicini E , et al. Reference values of urinary neutrophil gelatinase-associated lipocalin in very low birth weight infants. Pediatr Res 2009; 66: 528-532
- 14 Tanyeri B, Aygun C, Bedir A, Kucukhoduk S, Ozkaya O. Angiotensin converting enzyme gene polymorphisms and acute renal failure in babies with RDS. Early Hum Dev 2008; 84: S99
- 15 Haase M, Devarajan P, Haase-Fielitz A , et al. The outcome of neutrophil gelatinase-associated lipocalin-positive subclinical acute kidney injury: a multicenter pooled analysis of prospective studies. J Am Coll Cardiol 2011; 57: 1752-1761
- 16 Parravicini E, Nemerofsky SL, Michelson KA , et al. Urinary neutrophil gelatinase-associated lipocalin is a promising biomarker for late onset culture-positive sepsis in very low birth weight infants. Pediatr Res 2010; 67: 636-640
- 17 Zappitelli M, Washburn KK, Arikan AA , et al. Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study. Crit Care 2007; 11: R84
- 18 Mishra J, Dent C, Tarabishi R , et al. Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet 2005; 365: 1231-1238
- 19 Cai L, Rubin J, Han W, Venge P, Xu S. The origin of multiple molecular forms in urine of HNL/NGAL. Clin J Am Soc Nephrol 2010; 5: 2229-2235
- 20 Mussap M, Noto A, Fravega M, Fanos V. Urine neutrophil gelatinase-associated lipocalin (uNGAL) and netrin-1: are they effectively improving the clinical management of sepsis-induced acute kidney injury (AKI)?. J Matern Fetal Neonatal Med 2011; 24 (Suppl. 02) 15-17
- 21 Nickolas TL, Forster CS, Sise ME , et al. NGAL (Lcn2) monomer is associated with tubulointerstitial damage in chronic kidney disease. Kidney Int 2012; ; June 13 (Epub ahead of print)