Urine Biomarkers Predict Acute Kidney Injury in Newborns - 24/07/12
, Rajesh Koralkar, MPH 2, Hayden E. Hundley, MPH 3, Angela Montesanti, MPH 4, Pushkar Parwar, MBBS, MPH 1, Srdjan Sonjara, BS, BA 5, Namasivayam Ambalavanan, MD 1
Reprint requests: David J. Askenazi, MD, MSPH, University of Alabama at Birmingham, Department of Pediatrics, Division of Nephrology, 1600 7th Ave South, ACC 516, Birmingham, AL 35233.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, β2 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.
Le texte complet de cet article est disponible en PDF.Mots-clés : AKI, AUC, B2mG, Cys C, CV, EGF, KIM-1, NGAL, OPN, SCr, UMOD
Plan
| Supported by a The Normal Siegel Scholar Young Investigator Award from the American Society of Nephrology. (to D.A.), the Kaul Pediatric Research Institute, and a pilot and feasibility grant from the National Institutes of Health–sponsored O’Brien Center for Acute Kidney Injury research (www.obrienaki.org). D.A. serves as consultant and is on the speaker’s bureau for Gambro Renal Products. The other authors declare no conflicts of interest. |
Vol 161 - N° 2
P. 270 - août 2012 Retour au numéro
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