title: Is urinary neutrophil gelatinase-associated lipocalin able to predict acute kidney injury episodes in very low birth weight infants in clinical settings?
abstract: We evaluated the potential utility of elevated urinary neutrophil gelatinase-associated lipocalin (UNGAL) concentration as a screening test for early identification of acute kidney injury (AKI) in very low birth weight (VLBW) newborns.
  
  
  
  Urine for UNGAL analysis was collected prospectively daily until 32 wk postmenstrual age in 91 VLBW newborns, yielding 2,899 specimens. UNGAL values > 50 ng/ml were considered elevated. AKI was defined as two or more consecutive elevations in s[Cr] above the 95thpercentile adjusted for gestational age and chronological age within a 48 h period. We compared UNGAL values taken during the 5 d prior to AKI onset (pre-AKI) to values taken during non-AKI days.
  
  
  
  Overall, 15 episodes of AKI were identified in 13 infants. UNGAL was available in 44 pre-AKI days and 969 non-AKI days. UNGAL > 50 ng/ml occurred more often in pre-AKI days than in non-AKI days (risk ratio 3.48 (1.89, 6.40)). Positive and negative likelihood ratios were 1.92 (1.52, 2.41) and 0.52 (0.34, 0.78), respectively.
  
  
  
  Although UNGAL elevation > 50 ng/ml discriminates between pre-AKI and non-AKI days, high false positive and false negative rates limit utility as a screening test in VLBW newborns.
authors.affiliation: Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: Elvira
authors.initials: E
authors.lastname: Parravicini
authors.affiliation: Department of Pediatrics, University of Bologna, Bologna, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Locatelli
authors.affiliation: Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: John M
authors.initials: JM
authors.lastname: Lorenz
authors.affiliation: Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Nemerofsky
authors.affiliation: Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York.
authors.forename: David A
authors.initials: DA
authors.lastname: Bateman
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine; D004573:Electrolytes; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016013:Likelihood Functions; D000071068:Lipocalin-2 / Q000652:urine*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D004573:Electrolytes; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D003404:Creatinine