Increased urinary neutrophil gelatinase-associated lipocalin in very-low-birth-weight infants with oliguria and normal serum creatinine
| Autor: | Sang Lak Lee, Jae Hyun Park, Won Mok Lee, Ji Yong Ha, So Young Shin |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Urinary system Birth weight Oliguria Gestational Age Urine 030204 cardiovascular system & hematology Kidney Function Tests Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Lipocalin-2 Intensive Care Units Neonatal Proto-Oncogene Proteins 030225 pediatrics Internal medicine medicine Humans Infant Very Low Birth Weight Cystatin C Retrospective Studies Creatinine business.industry Infant Newborn Area under the curve Gestational age Hospitalization Low birth weight chemistry Nephrology Area Under Curve Pediatrics Perinatology and Child Health Apgar Score medicine.symptom business Biomarkers |
| Zdroj: | Pediatric Nephrology. 32:1059-1065 |
| ISSN: | 1432-198X 0931-041X |
| DOI: | 10.1007/s00467-016-3572-5 |
| Popis: | In infants, oliguria is defined as a urine output of1.5 mL/kg/h. The aim of our study was to assess the impact of oliguria on urinary neutrophil gelatinase-associated lipocalin (NGAL) and serum cystatin C (CysC) levels in very-low-birth-weight infants (VLBWIs) with a normal serum creatinine (Cr) level.Fifty-seven VLBWIs were enrolled in the study. Urinary NGAL, serum CysC and Cr levels and urinary NGAL/Cr ratios were measured. Infants with Apgar scores of5 at 5 min and/or a serum Cr level of1.5 mg/dL or those treated for patent ductus arteriosus were excluded. In case of antibiotic treatment, blood and urine samples were collected at ≥48 h after discontinuation of antibiotic treatment.There was a significant difference in gestational age between infants with oliguric episodes during hospitalization and those without, but not in birth weight, perinatal or postnatal factors. Gestational age was negatively correlated with urinary NGAL and serum CysC levels and urinary NGAL/Cr ratio (p0.05), whereas postnatal age was negatively correlated with serum Cr level and urinary NGAL/Cr ratio (p0.05). Of the 117 urine and blood samples collected, 25 (21.4%) were obtained from neonates with oliguric episodes. After adjusting for gestational age and postnatal age, comparison of samples collected in infants with and without oliguric episodes revealed significant differences in the mean level of urinary NGAL and in the urinary NGAL/Cr ratio, but not in mean serum CysC or serum Cr levels. The urinary NGAL level [area under the curve (AUC) 0.886, 95% confidence interval (CI) 0.814-0.937] and urinary NGAL/Cr ratio (AUC 0.853, 95% CI 0.775-0.911) showed significantly greater discrimination for oliguria than serum CysC (AUC 0.610, 95% CI: 0.515-0.699) or serum Cr (AUC 0.747, 95%CI 0.659-0.823) levels.Urinary NGAL level and urinary NGAL/Cr ratio were more sensitive markers for the presence of oliguria in VLBWIs with normal serum Cr levels than serum CysC level. |
| Databáze: | OpenAIRE |
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