Use of urine neutrophil gelatinase-associated lipocalin for nephrotoxic medication acute kidney injury screening in neonates.

Autor: Slagle CL; Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. cslagle@iuhealth.org.; Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. cslagle@iuhealth.org.; Riley Hospital for Children at Indiana University Health and Indiana University School of Medicine, Indianapolis, IN, USA. cslagle@iuhealth.org., Hemmelgarn T; Division of Pharmacy, Cincinnati Children's Hospital, Cincinnati, OH, USA., Gavigan HW; Division of Nephrology, Levine Children's Hospital, Charlotte, NC, USA., Krallman KA; Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.; Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Goldstein SL; Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.; Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2024 Dec; Vol. 44 (12), pp. 1780-1785. Date of Electronic Publication: 2024 Mar 21.
DOI: 10.1038/s41372-024-01922-6
Abstrakt: Background: Daily serum creatinine monitoring protocols for acute kidney injury (AKI) are invasive and may lead to surveillance resistance. We aimed to understand if use of urine neutrophil gelatinase-associated lipocalin (uNGAL) could increase high-risk nephrotoxic medication (NTMx) associated AKI screening adherence in neonates.
Methods: Statistical process control methods prior to and post implementation were trended. The primary outcome, screening adherence, was defined as either daily serum creatinine or uNGAL assessment through 2 days post high-risk NTMx exposure.
Results: 1291 monitoring days from the pre-implementation era (4/2020-6/2021) were compared to1377 monitoring days from the post-era (6/2021-10/2022). AKI screening adherence increased (81 to 92%) following implementation of optional uNGAL screening. Urine NGAL accounted for 35% of screening obtained. Use of uNGAL resulted in a 40% reduction in blood sampling for serum creatinine.
Conclusions: Incorporation of uNGAL as a complementary screening tool to serum creatinine demonstrated sustained increased AKI surveillance in our Baby NINJA monitoring program.
Competing Interests: Competing interests: Cara Slagle, MD is a consultant for AM Pharma and Medtronic and has received honorariums from Medtronic, the University of Alabama, and the AKI Critical Care Foundation, all unrelated to the work above. Stuart Goldstein, MD and Cincinnati Children’s Hospital receive royalties from Vigilanz Corporation (Minneapolis, MN) for the NINJA application licensed to Vigilanz from Cincinnati Children’s Hospital Medical Center. Dr. Goldstein consults and receives research funding from BioPorto Diagnostics, Inc, which markets The ProNephroAKI NGAL Test™.
(© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
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