title: Early urinary biomarkers of acute kidney injury in preterm infants.
abstract: Acute kidney injury (AKI) in the neonatal intensive care setting is multifactorial and is associated with significant morbidity and mortality. This study evaluates the utility of novel urinary biomarkers to predict the development and/or severity AKI in preterm infants.
  
  
  
  We performed a case-control study on a prospective cohort of preterm infants (<32 wk), to compare seven urine biomarkers between 25 infants with AKI and 20 infants without AKI.
  
  
  
  Infants with AKI had significantly higher neutrophil gelatinase-associated lipocalin (NGAL) (median, control (CTRL) vs. AKI; 0.598 vs. 4.24 µg/ml; P < 0.0001). In contrast, urinary epidermal growth factor (EGF) levels were significantly lower in infants who developed AKI compared to controls (median, CTRL vs. AKI; 0.016 vs. 0.006 µg/ml; P < 0.001). The area under the curve (AUC) for NGAL for prediction of stage I AKI on the day prior to AKI diagnosis (day-1) was 0.91, and for the prediction of stage II/III, AKI was 0.92. Similarly, urine EGF was a predictor of renal injury on day -1 (AUC: 0.97 for stage I and 0.86 for stage II/III AKI).
  
  
  
  Urinary biomarkers may be useful to predict AKI development prior to changes in serum creatinine (SCr) in preterm infants.
authors.affiliation: Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky.
authors.forename: Mina
authors.initials: M
authors.lastname: Hanna
authors.affiliation: Department of Pediatrics, University of Iowa, Iowa City, Iowa.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Brophy
authors.affiliation: Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Giannone
authors.affiliation: Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky.
authors.forename: Mandar S
authors.initials: MS
authors.lastname: Joshi
authors.affiliation: Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky.
authors.forename: John A
authors.initials: JA
authors.lastname: Bauer
authors.affiliation: O'Brien Center for AKI Research, University of California-San Diego, San Diego, California.|Department of Cell Biology and Molecular Genetics, Devaraj Urs Medical College, Kolar, India.
authors.forename: Satish
authors.initials: S
authors.lastname: RamachandraRao
mesh_terms: D058186:Acute Kidney Injury / Q000652:urine*; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine*; D016022:Case-Control Studies; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D000071068:Lipocalin-2 / Q000097:blood; D008297:Male; D008423:Maternal Age; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D003404:Creatinine