title: Urine biomarkers predict acute kidney injury in newborns.
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.
  
  
  METHODS
  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, β(2) 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.
  
  
  CONCLUSIONS
  Urinary biomarkers can predict AKI in neonates admitted to level 2 and 3 neonatal intensive care units.
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233, USA. daskenazi@peds.uab.edu
authors.forename: David J
authors.initials: DJ
authors.lastname: Askenazi
authors.forename: Rajesh
authors.initials: R
authors.lastname: Koralkar
authors.forename: Hayden E
authors.initials: HE
authors.lastname: Hundley
authors.forename: Angela
authors.initials: A
authors.lastname: Montesanti
authors.forename: Pushkar
authors.initials: P
authors.lastname: Parwar
authors.forename: Srdjan
authors.initials: S
authors.lastname: Sonjara
authors.forename: Namasivayam
authors.initials: N
authors.lastname: Ambalavanan
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis*; D000209:Acute-Phase Proteins / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine*; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000652:urine; D004815:Epidermal Growth Factor / Q000652:urine; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007231:Infant, Newborn; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine; D053495:Osteopontin / Q000652:urine; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000652:urine; D011991:Receptors, Virus; D058949:Uromodulin / Q000652:urine
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus; D058949:Uromodulin; D053495:Osteopontin; D004815:Epidermal Growth Factor; D003404:Creatinine