Longitudinal patterns of urine biomarkers in infants across gestational ages

DeFreitas, Marissa; Seeherunvong, Wacharee; Katsoufis, Chryso; RamachandraRao, Satish P.; Duara, Shahnaz; Yasin, Salih; Zilleruelo, Gastón; Rodríguez, Maria M.; Abitbol, Carolyn

doi:10.1007/s00467-016-3327-3

Cited by 39 publications

(31 citation statements)

References 37 publications

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“…A study by Chen et al reported that the median value of urine NGAL in third day of life in term infants was 88.1 ng/mL . Even higher urine NGAL levels on first day of life was published by DeFreitas et al, but the study only comprised 13 neonates . In contrast to our study, Sarafidis et al found much lower urine NGAL levels in a healthy reference group, which were 6.8 ng/mL (25–75% interquartiles 3.1–15.2 ng/mL), 7.1 ng/mL (2.7–17.7 ng/mL) and 1.1 ng/mL (0.9–1.9 ng/mL) on the first, third and tenth day of life, respectively .…”

Section: Table Of Demographics and Results According To Gendercontrasting

confidence: 92%

Health term‐born girls had higher levels of urine neutrophil gelatinase‐associated lipocalin than boys during the first postnatal days

et al. 2016

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Section: Table Of Demographics and Results According To Gendercontrasting

confidence: 92%

Health term‐born girls had higher levels of urine neutrophil gelatinase‐associated lipocalin than boys during the first postnatal days

et al. 2016

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“…No information on the PDA was given in that study [33]. Urinary albumin has been found to be increased in preterm neonates with asphyxia and respiratory distress and has been suggested as a possible biomarker of AKI in newborns [32, 34] and preterm neonates [35]. In concordance with our findings FENa is known to be very high in preterm neonates and inversely related to gestational age [36].…”

Section: Discussionsupporting

confidence: 86%

Urinary Neutrophil Gelatinase-associated Lipocalin in the evaluation of Patent Ductus Arteriosus and AKI in Very Preterm Neonates: a cohort study

et al. 2017

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BackgroundA patent ductus arteriosus (PDA) is frequently found in very preterm neonates and is associated with increased risk of morbidity and mortality. A shunt across a PDA can result in an unfavorable distribution of the cardiac output and may in turn result in poor renal perfusion. Urinary Neutrophil Gelatinase-associated Lipocalin (U-NGAL) is a marker of renal ischemia and may add to the evaluation of PDA. Our primary aim was to investigate if U-NGAL is associated with PDA in very preterm neonates. Secondary, to investigate whether U-NGAL and PDA are associated with AKI and renal dysfunction evaluated by fractional excretion of sodium (FENa) and urine albumin in a cohort of very preterm neonates.MethodsA cohort of 146 neonates born at a gestational age less than 32 weeks were consecutively examined with echocardiography for PDA and serum sodium, and urine albumin and sodium were measured on postnatal day 3 and U-NGAL and serum creatinine day 3 and 6. AKI was defined according to modified neonatal Acute Kidney Injury Network (AKIN) criteria. The association between U-NGAL and PDA was investigated. And secondly we investigated if PDA and U-NGAL was associated with AKI and renal dysfunction.ResultsU-NGAL was not associated with a PDA day 3 when adjusted for gestational age and gender. A PDA day 3 was not associated with AKI when adjusted for gestational age and gender; however, it was associated with urine albumin. U-NGAL was not associated with AKI, but was found to be associated with urine albumin and FENa.ConclusionsBased on our study U-NGAL is not considered useful as a diagnostic marker to identify very preterm neonates with a PDA causing hemodynamic changes resulting in early renal morbidity. The interpretation of NGAL in preterm neonates remains to be fully elucidated.

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“…In a prospective study of 252 children who presented to the emergency department, urinary β 2 M, NGAL, and KIM-1 demonstrated good accuracy (AUC > 0.7–0.8) in predicting AKI (192). The caveat with using β 2 M as a biomarker for AKI is that the level varies with gestational age, hence caution will need to be exercised in using this serum marker in premature infants (193, 194). …”

Section: Urinary β2m For the Assessment Of Tubular Functionmentioning

confidence: 99%

Rediscovering Beta-2 Microglobulin As a Biomarker across the Spectrum of Kidney Diseases

et al. 2017

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There is currently an unmet need for better biomarkers across the spectrum of renal diseases. In this paper, we revisit the role of beta-2 microglobulin (β2M) as a biomarker in patients with chronic kidney disease and end-stage renal disease. Prior to reviewing the numerous clinical studies in the area, we describe the basic biology of β2M, focusing in particular on its role in maintaining the serum albumin levels and reclaiming the albumin in tubular fluid through the actions of the neonatal Fc receptor. Disorders of abnormal β2M function arise as a result of altered binding of β2M to its protein cofactors and the clinical manifestations are exemplified by rare human genetic conditions and mice knockouts. We highlight the utility of β2M as a predictor of renal function and clinical outcomes in recent large database studies against predictions made by recently developed whole body population kinetic models. Furthermore, we discuss recent animal data suggesting that contrary to textbook dogma urinary β2M may be a marker for glomerular rather than tubular pathology. We review the existing literature about β2M as a biomarker in patients receiving renal replacement therapy, with particular emphasis on large outcome trials. We note emerging proteomic data suggesting that β2M is a promising marker of chronic allograft nephropathy. Finally, we present data about the role of β2M as a biomarker in a number of non-renal diseases. The goal of this comprehensive review is to direct attention to the multifaceted role of β2M as a biomarker, and its exciting biology in order to propose the next steps required to bring this recently rediscovered biomarker into the twenty-first century.

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Longitudinal patterns of urine biomarkers in infants across gestational ages

Abstract: Among healthy neonates, urinary biomarkers vary with GA. These data support the use of urinary biomarkers in the assessment of normal kidney development in the absence of injury.

Cited by 39 publications

References 37 publications

Health term‐born girls had higher levels of urine neutrophil gelatinase‐associated lipocalin than boys during the first postnatal days

Health term‐born girls had higher levels of urine neutrophil gelatinase‐associated lipocalin than boys during the first postnatal days

Urinary Neutrophil Gelatinase-associated Lipocalin in the evaluation of Patent Ductus Arteriosus and AKI in Very Preterm Neonates: a cohort study

Rediscovering Beta-2 Microglobulin As a Biomarker across the Spectrum of Kidney Diseases

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