Urine acute kidney injury biomarkers in extremely low gestational age neonates: a nested case control study of 21 candidate urine biomarkers.

Autor: Askenazi DJ; Department of Pediatrics, University of Alabama at Birmingham, 1600 5th Avenue South, Birmingham, AL, 35233, USA. daskenazi@peds.uab.edu., Halloran BA; Department of Pediatrics, University of Alabama at Birmingham, 1600 5th Avenue South, Birmingham, AL, 35233, USA., Heagerty PJ; Department of Biostatistics, University of Washington, Seattle, WA, USA., Schmicker RH; Department of Biostatistics, University of Washington, Seattle, WA, USA., Juul SE; Department of Pediatrics, University of Washington/Seattle Children's Hospital, Seattle, WA, USA., Hingorani S; Department of Pediatrics, University of Washington/Seattle Children's Hospital, Seattle, WA, USA., Goldstein SL; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2023 Apr; Vol. 38 (4), pp. 1329-1342. Date of Electronic Publication: 2022 Aug 01.
DOI: 10.1007/s00467-022-05688-x
Abstrakt: Background: Acute kidney injury (AKI) is common and is associated with poor clinical outcomes in premature neonates. Urine biomarkers hold the promise to improve our understanding and care of patients with kidney disease. Because kidney maturation and gender can impact urine biomarker values in extremely low gestational age neonates (ELGANs), careful control of gestational age (GA) and time is critical to any urine biomarker studies in neonates.
Methods: To improve our understanding of the potential use of urine biomarkers to detect AKI during the first postnatal weeks, we performed a nested case-control study to evaluate 21 candidate urine AKI biomarkers. Cases include 20 ELGANs with severe AKI. Each case was matched with 2 controls for the same GA week (rounded down to the nearest week), gender, and birth weight (BW) (± 50 g).
Results: Urine cystatin C, creatinine, ghrelin, fibroblast growth factor-23 (FGF23), tissue metalloproteinase 2 (TIMP2) and vascular endothelial growth factor A (VEGFa) concentrations were higher in ELGANs with early severe AKI compared to matched control subjects without AKI. Urine epidermal growth factor (EGF) and uromodulin (UMOD) concentrations are lower in cases than controls. Interleukin (IL)-15 was lower on day 1, but higher on day 8 in cases than controls; while VEGFa was lower on day 1, but higher on day 5 in cases than controls.
Conclusion: Urine biomarkers hold the promise to improve our ability to reliably detect kidney injury. Interventional studies are needed to determine the biomarkers' ability to predict outcomes, enhance AKI phenotypes, and improve timely interventions which can prevent the sequalae of AKI in ELGANs. A higher resolution version of the Graphical abstract is available as Supplementary information.
(© 2022. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje