title: Urinary neutrophil gelatinase-associated lipocalin is an early predictor of acute kidney injury in premature infants.
abstract: Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is produced in response to tubular epithelial injury and is a biomarker of tubulointerstitial injury. The aim of the present study was to examine whether acute kidney injury (AKI) could be predicted by measuring uNGAL in very low-birth weight (VLBW) infants. Forty VLBW infants with birthweight below 1,500 g were enrolled in the present study. uNGAL and serum creatinine (sCre) were measured daily from postnatal days 0 to 8. Infants with sCre ≥1.2 mg/dl were diagnosed with AKI. The relationship of uNGAL with sCre was measured on the day after uNGAL measurement (next-day sCre) was examined. The results showed that 16 infants had sCre ≥1.2 mg/dl in this period. Logistic regression analysis revealed that uNGAL on postnatal days 2, 3, 4, 5 and 6 was correlated with next-day sCre (P<0.05). uNGAL corrected by urinary Cre (uCre) (uNGAL/uCre) was only correlated with an increase in next-day sCre on postnatal days 5 and 6 (P<0.05). For the logistic analysis, subjects with high and low uNGAL levels based on the median value for each day, uNGAL on postnatal days 2, 3 and 6 in the high uNGAL group was correlated with an increase in next-day sCre. Thus, AKI may be predicted by measuring uNGAL in VLBW infants. This measurement was non-invasive, and is potentially useful for the evaluation of renal function in VLBW infants.
authors.affiliation: Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Kuribayashi
authors.affiliation: Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suzumura
authors.affiliation: Department of Public Health, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: Toshimi
authors.initials: T
authors.lastname: Sairenchi
authors.affiliation: Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Watabe
authors.affiliation: Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Tsuboi
authors.affiliation: Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: George
authors.initials: G
authors.lastname: Imataka
authors.affiliation: Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: Hidemitsu
authors.initials: H
authors.lastname: Kurosawa
authors.affiliation: Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Arisaka
keywords: acute kidney injury; prediction; serum creatinine; urinary NGAL; very low-birth weight infant