title: Factors limiting usefulness of serum and urinary NGAL as a marker of acute kidney injury in preterm newborns.
abstract: BACKGROUND
  Neutrophil gelatinase-associated lipocalin (NGAL) is postulated to be a highly sensitive and specific marker of acute kidney injury (AKI). The aim of this study was to assess the factors affecting serum and urine total NGAL in preterm newborns, limiting the role of this new potential marker of AKI.
  
  
  METHODS
  Serum and urinary total NGAL concentrations were determined in 57 preterm infants admitted to the Neonatal Intensive Care Unit in the following points of time: first week of life, between 8 and 14 days of life, and after the fourth week of life. Patients' clinical conditions were evaluated based on NTISS (Neonatal Therapeutic Intervention Scoring System). Two gestational age subgroups were distinguished: ≤29 and 30 to 35 weeks of gestation. We sought correlation between total NGAL values and gestational age, birth weight, Apgar score and severity of clinical condition, with particular interest in inflammatory status.
  
  
  RESULTS
  Serum and urinary total NGAL concentration correlated with inflammatory markers, such as CRP and procalcitonin, as well as with NTISS values. Birth weight and gestational age influence urinary NGAL (uNGAL) values in the first two weeks of life. In AKI (N = 8) patients uNGAL values were significantly higher than in non-AKI newborns.
  
  
  CONCLUSIONS
  We conclude that inflammatory status and prematurity limits the specificity of total NGAL measurement as a marker of AKI.
authors.affiliation: Department of Neonatal Intensive Care, Faculty of Medicine in Katowice, Upper Silesian Centre of Child's Health, Medical University of Silesia , Katowice , Poland and.
authors.forename: Anna
authors.initials: A
authors.lastname: Suchojad
authors.forename: Anna
authors.initials: A
authors.lastname: Tarko
authors.forename: Mike
authors.initials: M
authors.lastname: Smertka
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Majcherczyk
authors.forename: Aniceta
authors.initials: A
authors.lastname: Brzozowska
authors.forename: Jolanta
authors.initials: J
authors.lastname: Wroblewska
authors.forename: Iwona
authors.initials: I
authors.lastname: Maruniak-Chudek
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D000209:Acute-Phase Proteins / Q000652:urine; D001034:Apgar Score; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D007677:Kidney Function Tests / Q000379:methods; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood / Q000652:urine; D008297:Male; D011518:Proto-Oncogene Proteins / Q000097:blood / Q000652:urine; D012044:Regression Analysis; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D003404:Creatinine
keywords: Acute kidney injury; NGAL; creatinine; kidney function; perinatal asphyxia; preterm newborns; sepsis