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Am J Perinatol 2025; 42(05): 683-688
DOI: 10.1055/a-2417-4087
Original Article

Urinary Neutrophil Gelatinase-Associated Lipocalin Values in Preterm Neonates: A Systematic Review and Meta-analysis

Tahagod Mohamed
1   Division of Nephrology and Hypertension, Department of Pediatric, Nationwide Children's Hospital, Columbus, Ohio
2   The Kidney and Urinary Tract Center, Department of Pediatric, Nationwide Children's Hospital, Columbus, Ohio
,
Robin Alexander
3   Center for Biostatistics, The Ohio State University, Columbus, Ohio
,
Brielle Davidson
4   The Ohio State University College of Medicine, Columbus, Ohio
,
Brett Klamer
2   The Kidney and Urinary Tract Center, Department of Pediatric, Nationwide Children's Hospital, Columbus, Ohio
,
Alison Gehred
5   Nationwide Children's Hospital, Columbus, Ohio
,
Michelle C. Starr 
6   Division of Pediatric Nephrology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
,
Cara Slagle
7   Division of Neonatal-Perinatal Medicine, Riley Children's Hospital, Indiana University, Indianapolis, Indiana
,
Catherine Krawczeski
8   Division of Pediatric Cardiology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
,
Matthew W. Harer 
9   Division of Neonatology, Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin
› Author Affiliations Funding None.
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Abstract

Objective

Acute kidney injury (AKI) is common in hospitalized preterm neonates. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a promising noninvasive AKI biomarker. However, normal values of uNGAL in preterm neonates without AKI are poorly characterized. The objective of this study was to evaluate the current literature to determine normal uNGAL values for preterm neonates without AKI.

Study Design

Systematic review and meta-analysis of all articles published before November 2021 evaluating uNGAL values in preterm neonates without AKI.

Results

Of 1,607 studies evaluated for eligibility, 11 were included in the final meta-analysis (210 males, 202 females). uNGAL values were higher in the preterm neonates <29 weeks and ranged between 20.7 and 782.65 ng/mL. Meta mean estimates of gestational age (GA), birthweight, and neutrophil gelatinase-associated lipocalin were 29.4 weeks (95% confidence interval [CI]: 28.8–30.0), 1,241 g (95% CI: 1,111–1,372), and 148.9 ng/mL (95% CI: 48–231), respectively.

Conclusion

In limited studies, a wide range of uNGAL values in preterm neonates without AKI are reported. Future studies should identify normal uNGAL values in preterm neonates using larger cohorts by GA and birthweight.

Key Points

  • Urinary NGAL is a promising noninvasive biomarker of neonatal AKI.

  • A wide range of uNGAL is reported in preterm neonates but the baseline values are not well defined.

  • Urine NGAL values are higher in extremely preterm compared with preterm neonates.

Keywords

NGAL - neonatal AKI - acute kidney injury - urine NGAL - urinary NGAL

Supplementary Material



Publication History

Received: 29 March 2024

Accepted: 17 September 2024

Article published online:
22 October 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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