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Increased urinary neutrophil gelatinase-associated lipocalin in very-low-birth-weight infants with oliguria and normal serum creatinine

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Author(s)
So Young ShinJi Yong HaSang Lak LeeWon Mok LeeJae Hyun Park
Keimyung Author(s)
Lee, Sang LakPark, Jae HyunLee, Won MokHa, Ji Yong
Department
Dept. of Laboratory Medicine (진단검사의학)
Dept. of Urology (비뇨의학)
Dept. of Pediatrics (소아청소년학)
Journal Title
Pediatric Nephrology
Issued Date
2017
Volume
32
Issue
6
Keyword
Neutrophil gelatinase-associated lipocalinSerum cystatin CVery-low-birth-weight infantOliguriaRenal biomarkers
Abstract
Background; In infants, oliguria is defined as a urine output of
<1.5 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.
Methods; 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
of >5 at 5 min and/or a serum Cr level of >1.5 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.
Results; 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
(p < 0.05), whereas postnatal age was negatively correlated
with serum Cr level and urinary NGAL/Cr ratio (p < 0.05).
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.
Conclusions ;UrinaryNGAL 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.
Keimyung Author(s)(Kor)
이원목
하지용
박재현
이상락
Publisher
School of Medicine
Citation
So Young Shin et al. (2017). Increased urinary neutrophil gelatinase-associated lipocalin in very-low-birth-weight infants with oliguria and normal serum creatinine. Pediatric Nephrology, 32(6), 1059–1065. doi: 10.1007/s00467-016-3572-5
Type
Article
ISSN
0931-041X
Source
https://link.springer.com/article/10.1007%2Fs00467-016-3572-5
DOI
10.1007/s00467-016-3572-5
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32839
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학)
1. School of Medicine (의과대학) > Dept. of Pediatrics (소아청소년학)
1. School of Medicine (의과대학) > Dept. of Urology (비뇨의학)
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