title: Urine neutrophil gelatinase-associated lipocalin to predict acute kidney injury in preterm neonates. A pilot study.
abstract: BACKGROUND
  The efficacy of urine neutrophil gelatinase-associated lipocalin (uNGAL) as an early acute kidney injury (AKI) biomarker in preterm neonates was evaluated.
  
  
  METHODS
  Thirty-five preterm neonates were prospectively evaluated for serum creatinine (sCre)-documented AKI during the first 14 days of life. Urine samples were collected daily throughout the study period. Of the neonates evaluated, we analyzed 11 who developed AKI (cases) and an equal number of neonates without AKI (controls) matched for gestational and postnatal age (case-control study). uNGAL was measured on the day of AKI occurrence (day 0) and on the 2 days preceding the event (day -1 and day -2, respectively) using an enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Cases had significantly higher sCre levels than controls on day 0 (1.21 ± 0.48 vs. 0.83 ± 0.16 mg/dL, p =0.031) but not on days -1 and -2. Similarly, uNGAL levels (ng/mL) were significantly higher in cases than in controls only on day 0 (19.1 ± 3.5 vs. 13.3 ± 7.3, p=0.017) and not on days -1 (18.8 ± 3.4 vs. 16.3 ± 5.9, p=0.118) and -2 (19.3 ± 1.8 vs. 19.4 ± 0.8, p =0.979). The receiver operating characteristic curve analysis showed no significant ability of uNGAL to predict AKI on days -2 and -1.
  
  
  CONCLUSIONS
  In this pilot study in preterm neonates, although uNGAL detected sCre-based AKI upon its documentation, it failed to predict its development 1-2 days earlier.
authors.forename: Kosmas
authors.initials: K
authors.lastname: Sarafidis
authors.forename: Eleni
authors.initials: E
authors.lastname: Tsepkentzi
authors.forename: Elisavet
authors.initials: E
authors.lastname: Diamanti
authors.forename: Eleni
authors.initials: E
authors.lastname: Agakidou
authors.forename: Anna
authors.initials: A
authors.lastname: Taparkou
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Soubasi
authors.forename: Fotios
authors.initials: F
authors.lastname: Papachristou
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Drossou
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000652:urine*; D000209:Acute-Phase Proteins / Q000652:urine*; D015415:Biomarkers / Q000652:urine*; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D008297:Male; D010865:Pilot Projects; D047928:Premature Birth; D011518:Proto-Oncogene Proteins / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine
references.citation: Pediatr Res. 2008 Oct;64(4):423-8
references.pmid: 18552711
references.citation: Curr Opin Pediatr. 2011 Apr;23(2):194-200
references.pmid: 21252674
references.citation: Curr Opin Pediatr. 2012 Apr;24(2):191-6
references.pmid: 22227783
references.citation: Nephron Clin Pract. 2011;118(4):c315-8
references.pmid: 21293153
references.citation: Nephrol Dial Transplant. 2013 Feb;28(2):254-73
references.pmid: 23115326
references.citation: Crit Care. 2007;11(4):R84
references.pmid: 17678545
references.citation: Intensive Care Med. 2010 Aug;36(8):1333-40
references.pmid: 20397003
references.citation: Am J Respir Crit Care Med. 2011 Apr 1;183(7):907-14
references.pmid: 20935115
references.citation: Toxicol Pathol. 2012 Oct;40(7):1031-48
references.pmid: 22581810
references.citation: Pediatr Nephrol. 2012 Sep;27(9):1575-82
references.pmid: 22532328
references.citation: Arch Dis Child Fetal Neonatal Ed. 2005 Nov;90(6):F514-9
references.pmid: 16244211
references.citation: Intensive Care Med. 2013 Mar;39(3):541-2
references.pmid: 23242286
references.citation: J Pediatr. 2011 Jun;158(6):1009-1015.e1
references.pmid: 21300375
references.citation: Anesthesiology. 2006 Sep;105(3):485-91
references.pmid: 16931980
references.citation: Ren Fail. 2009;31(10):910-9
references.pmid: 20030526
references.citation: Pediatr Nephrol. 2012 Feb;27(2):303-11
references.pmid: 21809002
references.citation: J Pediatr. 2011 Dec;159(6):907-12.e1
references.pmid: 21784446
references.citation: Pediatr Res. 2009 Nov;66(5):528-32
references.pmid: 19680166
references.citation: Pediatr Nephrol. 2013 Jul;28(7):1127-34
references.pmid: 23519522
references.citation: Pediatr Res. 2011 Sep;70(3):302-6
references.pmid: 21646940
references.citation: J Am Soc Nephrol. 2003 Oct;14(10):2534-43
references.pmid: 14514731
references.citation: Res Nurs Health. 2013 Jun;36(3):320-4
references.pmid: 23408517
references.citation: J Perinatol. 2011 Mar;31(3):199-205
references.pmid: 20651693
references.citation: Lancet. 2005 Apr 2-8;365(9466):1231-8
references.pmid: 15811456
references.citation: Nephrol Dial Transplant. 2011 May;26(5):1717-23
references.pmid: 21257679
references.citation: Pediatr Res. 2011 Apr;69(4):354-8
references.pmid: 21178824