Early urinary biomarkers of acute kidney injury in preterm infants

Mina Hanna, Patrick D. Brophy, Peter J. Giannone, Mandar S. Joshi, John A. Bauer, Satish Ramachandrarao

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Background: Acute kidney injury (AKI) in the neonatal intensive care setting is multifactorial and is associated with significant morbidity and mortality. This study evaluates the utility of novel urinary biomarkers to predict the development and/or severity AKI in preterm infants. Methods: We performed a case-control study on a prospective cohort of preterm infants (<32 wk), to compare seven urine biomarkers between 25 infants with AKI and 20 infants without AKI. Results: Infants with AKI had significantly higher neutrophil gelatinase-associated lipocalin (NGAL) (median, control (CTRL) vs. AKI; 0.598 vs. 4.24 μg/ml; P < 0.0001). In contrast, urinary epidermal growth factor (EGF) levels were significantly lower in infants who developed AKI compared to controls (median, CTRL vs. AKI; 0.016 vs. 0.006 μg/ml; P < 0.001). The area under the curve (AUC) for NGAL for prediction of stage I AKI on the day prior to AKI diagnosis (day-1) was 0.91, and for the prediction of stage II/III, AKI was 0.92. Similarly, urine EGF was a predictor of renal injury on day -1 (AUC: 0.97 for stage I and 0.86 for stage II/III AKI). Conclusion: Urinary biomarkers may be useful to predict AKI development prior to changes in serum creatinine (SCr) in preterm infants.

Original languageEnglish
Pages (from-to)218-223
Number of pages6
JournalPediatric Research
Volume80
Issue number2
DOIs
StatePublished - Aug 1 2016

Bibliographical note

Publisher Copyright:
© 2016 International Pediatric Research Foundation, Inc.

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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