title: Endothelin-1 levels and renal function in newborns of various gestational ages.
abstract: BACKGROUND
  Renal failure is common in the NICU; Acute Kidney Injury (AKI) occurs in 8-24% of admissions. Although AKI is preventable with early diagnosis, no reliable AKI biomarkers exist. Endothelin-1 (ET-1) has been implicated in renal pathogenesis, and elevated urinary ET-1 (uET-1) levels may correlate with progression of renal dysfunction. The study objectives were to determine whether uET-1 levels correlate with renal function parameters and/or fetal growth restriction, and if uET-1 is a potential neonatal AKI biomarker.
  
  
  METHODS
  Sixty-three neonates were enrolled and divided into gestational age (GA) groups by weeks: 1) (24-30 6/7; n = 24); 2) (31-36 6/7; n = 26); and 3) (37-42; n = 13). Additional preterm subgroups for fetal growth restriction analysis included: 1) Appropriate for GA (AGA; n = 40), and 2) Small for GA (SGA; n = 10). ET-1 levels, measured using enzyme linked immunosorbent assay, were collected at birth (cord blood) and 24 h ( ± 4) of life (blood/urine).
  
  
  RESULTS
  No correlation was found between uET-1 and blood plasma levels at birth (r = 0.15; p > 0.05) or 24 h (r = 0.17; p > 0.05). uET-1 negatively correlated with GA (r = -0.44; p < 0.001) and GFR (r = -0.34; p < 0.01). uET-1 levels did not correlate with creatinine (r = 0.13; p > 0.05), BUN (r = 0.19; p > 0.05), BUN/Cr ratio (r = 0.15; p > 0.05), or urinary output (r = 0.12; p > 0.05). In fetal growth restriction subgroup analyses: uET-1 levels negatively correlated with GFR in the PT-AGA subgroup (r = -0.38; p = 0.017), but not with PT-SGA (r = 0.01; p > 0.05).
  
  
  CONCLUSIONS
  Plasma and uET-1 levels did not correlate; therefore, renal ET-1 excretion may reflect renal ET-1 production. uET-1 levels correlated negatively with GA and GFR. uET-1 may be a marker of impaired neonatal circulatory regulation and consequent renal injury.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Advocate Lutheran General Hospital/Advocate Children's Hospital, Park Ridge, IL, USA.|Advocate Medical Group, Park Ridge, IL, USA.
authors.forename: G
authors.initials: G
authors.lastname: Stefanov
authors.affiliation: Department of Pediatrics, Division of Neonatology, Advocate Lutheran General Hospital/Advocate Children's Hospital, Park Ridge, IL, USA.|Advocate Medical Group, Park Ridge, IL, USA.
authors.forename: B L
authors.initials: BL
authors.lastname: Puppala
authors.affiliation: Chicago College of Pharmacy, Midwestern University, Downers Grove, IL, USA.
authors.forename: G
authors.initials: G
authors.lastname: Pais
authors.affiliation: Chicago College of Pharmacy, Midwestern University, Downers Grove, IL, USA.
authors.forename: A
authors.initials: A
authors.lastname: Gulati
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D003404:Creatinine / Q000097:blood; D019332:Endothelin-1 / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005317:Fetal Growth Retardation / Q000097:blood* / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D014481:United States
chemical_list: D015415:Biomarkers; D019332:Endothelin-1; D003404:Creatinine
keywords: ET-1; Endothelin 1; newborn; renal function