Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
5-Year IF – 2.0, IF – 1.9, JCI (2024) – 0.43
Scopus CiteScore – 4.3
Q1 in SJR 2024, SJR score – 0.598, H-index: 49 (SJR)
ICV – 161.00; MNiSW – 70 pts
Initial editorial assessment and first decision within 24 h

ISSN 1899–5276 (print), ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 12, December, p. 1657–1666

doi: 10.17219/acem/110317

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

eGFR values and selected renal urine biomarkers in preterm neonates with uncomplicated clinical course

Monika Miklaszewska1,A,B,C,D, Przemysław Korohoda2,C,D,E, Dorota Drożdż1,E,F, Katarzyna Zachwieja1,B,E, Tomasz Tomasik3,B, Anna Moczulska1,B, Agata Korzeniecka-Kozerska4,C,E, Przemko Kwinta3,B,C,D,E,F

1 Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Kraków, Poland

2 Department of Electronics, Faculty of Computer Science, Electronics and Telecommunications, AGH University of Science and Technology, Kraków, Poland

3 Department of Pediatrics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

4 Department of Pediatrics and Nephrology, Medical University of Białystok, Poland

Abstract

Background. Diagnosing acute kidney injury (AKI) in preterm newborns, who are particularly susceptible to renal damage, is a serious challenge as there is no definite consensus about the diagnostic criteria.
Objectives. The objective of this study was to measure the values for selected urinary biomarkers and estimated glomerular filtration rate (eGFR) among a population of preterm infants with uncomplicated clinical course as well as to determine whether these markers depend on birth weight (BW), gestational age (GA), postnatal age (PNA), or gender.
Material and Methods. The prospective study was carried out in neonatal intensive care unit (NICU). The evaluation included 57 children that were divided into 3 categories according to BW: low birth weight (LBW) – 1501–2500 g (22 infants); very low birth weight (VLBW) – 1000–1500 g (25 infants); and extremely low birth weight (ELBW) – 750–999 g (10 infants). Urine samples were collected daily between the 4th and 28th day of life for measurements of creatinine (Cr), neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), and human kidney injury molecule 1 (hKIM1).
Results. The values of the 3 urine tubular biomarkers, serum creatinine and eGFR were taken in substantially healthy preterm infants with normal kidney function at 4 time intervals during the neonatal period. Their correlations were determined and a multivariable regression analysis was carried out with respect to BW, GA, PNA, and gender. Trends of the studied markers in terms of PNA and BW were also assessed with the Jonckheere–Terpstra test.
Conclusion. Glomerular and tubular function in preterm neonates during the 1st month of life is significantly influenced by BW, GA, PNA, and gender.

Key words

renal function, renal urine biomarkers, premature neonate

References (40)

  1. Gubhaju L, Sutherland MR, Horne R, et al. Assessment of renal functional maturation and injury in preterm neonates during the first month of life. Am J Physiol Renal Physiol. 2014;307(2):F149–F158.
  2. La Manna G, Galletti S, Capelli I, et al. Urinary neutrophil gelatinase-associated lipocalin at birth predicts early renal function in very low birth weight infants. Pediatr Res. 2011;70(4):379–383.
  3. Koralkar R, Ambalavanan N, Levitan EB, McGwin G, Goldstein S, Askenazi D. Acute kidney injury reduces survival in very low birth weight infants. Pediatr Res. 2011;69(4):354–358.
  4. Jetton JG, Askenazi DJ. Update on acute kidney injury in the neonate. Curr Opin Pediatr. 2012;24(2):191–196.
  5. Stojanović VD, Barišić NA, Vučković NM, Doronjski AD, Peco Antić AE. Urinary kidney injury molecule-1 rapid test predicts acute kidney injury in extremely low-birth-weight neonates. Pediatr Res. 2015;78(4):430–435.
  6. Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int. 2007;71(10):1028–1035.
  7. Abitbol CL, Bauer CR, Montané B, Chandar J, Duara S, Zilleruelo G. Longterm follow-up of extremely low birth weight infants with neonatal renal failure. Pediatr Nephrol. 2003;18(9):887–893.
  8. Libório AB, Pereira Castello Branco KM, Torres deMelo Bezerra C. Acute kidney injury in neonates: From urine output to new biomarkers. BioMed Res Int. 2014;2014:601568.
  9. Greenberg JH, Parikh CR. Biomarkers for diagnosis and prognosis of AKI in children: One size does not fit all. Clin J Am Soc Nephrol. 2017;12(9):1551–1557.
  10. Askenazi DJ, Koralkar R, Levitan EB, et al. Baseline values of candidate urine acute kidney injury biomarkers vary by gestational age in premature infants. Pediatr Res. 2011;70(3):302–306.
  11. Mishra J, Ma Q, Prada A, et al. Identification of neutrophil gelatinase-associated lipocalin as a novel early urinary biomarker for ischemic renal injury. J Am Soc Nephrol. 2003;14(10):2534–2543.
  12. Han WK, Bailly V, Abichandani R, Thadhani R, Bonventre JV. Kidney injury molecule-1 (KIM-1): A novel biomarker for human renal proximal tubule injury. Kidney Int. 2002;62(1):237–244.
  13. Liangos O, Perianayagam MC, Vaidya VS, et al. Urinary N-acetyl-beta-(D)-glucosaminidase activity and kidney injury molecule-1 level are associated with adverse outcomes in acute renal failure. J Am Soc Nephrol. 2007;18(3):904–912.
  14. Trof RJ, Di Maggio F, Leemreis J, Groeneveld AB. Biomarkers of acute renal injury and renal failure. Shock. 2006;26(3):245–253.
  15. Nguyen MT, Devarajan P. Biomarkers for the early detection of acute kidney injury. Pediatr Nephrol. 2008;23(12):2151–2157.
  16. Mori K, Lee HT, Rapoport D, et al. Endocytic delivery of lipocalin-siderophore-iron complex rescues the kidney from ischemia-reperfusion injury. J Clin Invest. 2005;115(3):610–621.
  17. 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(5):528–532.
  18. Xie Y, Sakatsume M, Nishi S, Narita I, Arakawa M, Gejyo F. Expression, roles, receptors, and regulation of osteopontin in the kidney. Kidney Int. 2001;60(5):1645–1657.
  19. Bailly V, Zhang Z, Meier W, Cate R, Sanicola M, Bonventre JV. Shedding of kidney injury molecule-1, a putative adhesion protein involved in renal regeneration. J Biol Chem. 2002;277(42):39739–39748.
  20. Coca SG, Yalavarthy R, Concato J, Parikh CR. Biomarkers for the diagnosis and risk stratification of acute kidney injury: A systematic review. Kidney Int. 2008;73(9):1008–1016.
  21. Thongboonkerd V, Malasit P. Renal and urinary proteomics: Current applications and challenges. Proteomics. 2005;5(4):1033–1042.
  22. Schwartz GJ, Munoz A, Schneider MF, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20(3):629–637.
  23. Chi-Nien C, Chia-Hung C, Suh-Fang J, et al. Urinary neutrophil gelatinase-associated lipocalin levels in neonates. Pediatr Neonatol. 2016;57(33):207–212.
  24. Bateman DA, Thomas W, Parravicini E, Polesana E, Locatelli C, Lorenz JM. Serum creatinine concentration in very-low-birth-weight infants from birth to 34–36 week postmenstrual age. Pediatr Res. 2015;77(5):696–702.
  25. Parravicini E, Lorenz JM, Nemerofsky SL, O’Rourke M, Barasch J, Bateman D. Reference range of urinary neutrophil gelatinase-associated lipocalin in very low-birth-weight infants: Preliminary data. Am J ­Perinatol. 2009;26(6):437–440.
  26. Noemi M, Ramirez M, Godoy LE, Barrientos EA. SNAP II and SNAPPE II as predictors of neonatal mortality in a pediatric intensive care unit: Does postnatal age play a role? Int J Pediatr. 2014;2014:298198.
  27. Dionne JM, Abitbol CL, Flynn JT. Hypertension in infancy: Diagnosis, management and outcome. Pediatr Nephrol. 2012;27(1):17–32.
  28. Selewski DT, Jordan BK, Askenazi DJ, Dechert RE, Sarkar S. Acute kidney injury in asphyxiated newborns treated with therapeutic hypothermia. J Pediatr. 2013;162(4):725–729.
  29. Alabbas A, Campbell A, Skippen P, Human D, Matsell D, Mammen C. Epidemiology of cardiac surgery-associated acute kidney injury in neonates: A retrospective study. Pediatr Nephrol. 2013;28(7):1127–1134.
  30. Elmas AT, Tabel Y, Ipek S. Determination of reference values for urinary neutrophil gelatinase-associated lipocalin in premature infants. J Matern Fetal Neonatal Med. 2014;27(2):187–191.
  31. Sarafidis K, Tsepkentzi E, Agakidou E, et al. Serum and urine acute kidney injury biomarkers in asphyxiated neonates. Pediatr Nephrol, 2012;27(9):1575–1582.
  32. Cangemi G, Storti S, Cantinotti M, et al. Reference values for urinary neutrophil gelatinase-associated lipocalin (NGAL) in pediatric age measured with a fully automated chemiluminescent platform. Clin Chem Lab Med. 2013;51(5):1101–1105.
  33. Askenazi DJ, Koralkar R, Patil N, Halloran B, Ambalavanan N, Griffin R. Acute kidney injury urine biomarkers in very low-birth-weight infants. Clin J Am Soc Nephrol. 2016;11(9):1527–1535.
  34. Askenazi DJ, Montesanti A, Hunley H, et al. Urine biomarkers predict acute kidney injury and mortality in very low birth weight infants. J Pediatr. 2011;159(6):907–912.
  35. Genc G, Ozkaya O, Avci B, Aygun C, Kucukoduk. Kidney injury molecule-1 as a promising biomarker for acute kidney injury in premature babies. Am J Perinatol. 2013;30(3):245–252.
  36. Youssef M, Abdelsalam M, Saeed R, Mohamed A. Urinary kidney injury molocule-1 level in preterm neonates with respiratory distress syndrome. Open J Pediatr. 2016;6(1):1–9.
  37. Kamianowska M, Szczepański M, Kulikowska EE, Bebko B, Wasilewska A. Do serum and urinary concentrations of kidney injury molecule-1 in healthy newborns depend on birth weight, gestational age or gender? J Perinatol. 2017;37(1):73–76.
  38. Lavery AP, Meinzen-Derr JK, Anderson E, et al. Urinary NGAL in premature infants. Pediatr Res. 2008;64(4):423–428.
  39. Suchojad A, Tarko A, Smertka M, et al. Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm newborns. Ren Fail. 2015;37(3):439–445.
  40. Aggarwal A, Kumar P, Chowdhary G, Majumdar S, Narang A. Evaluation of renal functions in asphyxiated newborns. J Trop Pediatr. 2005;51(5):295–299.
© Wroclaw Medical University