Reference Range of Urinary Neutrophil Gelatinase-Associated Lipocalin in Very Low-Birth-Weight Infants: Preliminary Data

Parravicini, Elvira; Lorenz, John M.; Nemerofsky, Sheri L.; O'Rourke, Matthew; Barasch, Jonathan; Bateman, David A.

doi:10.1055/s-0029-1214242

Cited by 20 publications

(22 citation statements)

References 6 publications

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“…Compared to previous reports the strengths of this study are a larger patient population, the daily urine collections for the first month of life in a portion of the study population, and exclusion of VLBW infants with complicated courses. This report provides normative UNGAL concentrations, further refining the preliminary data from a study of 22 infants with uncomplicated courses that we previously reported (25). No patients < 26 weeks gestation or birth weight ≤ 750 grams in this sample had uncomplicated clinical courses.…”

Section: Discussionsupporting

confidence: 71%

“…This is the third report of UNGAL concentrations in VLBW infants (25,28). Compared to previous reports the strengths of this study are a larger patient population, the daily urine collections for the first month of life in a portion of the study population, and exclusion of VLBW infants with complicated courses.…”

Section: Discussionmentioning

confidence: 75%

“…Its role in renal development raises the possibility that the reference range in premature infants may differ from that in adults and children. In a previous paper involving 22 VLBW infants with uncomplicated clinical courses, a preliminary reference range of UNGAL concentration was established based on urine samples collected weekly (25). By adding a larger number of infants with daily urine collections to this initial group, the current study aims to refine the reference range for UNGAL concentration in VLBW infants who have uncomplicated clinical courses and no risk factors for ARI and to determine whether this reference range varies with gestational and/or postnatal age.…”

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confidence: 99%

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Reference Values of Urinary Neutrophil Gelatinase-Associated Lipocalin in Very Low Birth Weight Infants

et al. 2009

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In very low birth weight (VLBW) infants, acute renal impairment (ARI) is common but there is no consensus about criteria for its diagnosis. Neutrophil gelatinase-associated lipocalin (NGAL) is an early and sensitive indicator of renal impairment in experimental animals, children, and adults. Urinary NGAL (UNGAL) is detectable in VLBW infants; however, there is no reference range in this population. The objective of this study is to define the reference range for UNGAL in VLBW infants with no risk factors for ARI. UNGAL concentration was determined in urine samples collected from day of life (DOL) 4 through DOL 30 in 50 newborns with uncomplicated clinical courses, selected from a total of 145 prospectively enrolled appropriate for gestational age (AGA) inborn VLBW premature infants. The birth weight and gestational age ranges were 790–1490 grams and 26–33 weeks, respectively. The median, 95th and 99th percentiles, and range of pooled UNGAL values were 5 ng/ml, 50 ng/ml, 120ng/ml, and 2–150 ng/ml, respectively. Greater variability and higher quantile levels of UNGAL were observed in females vs. males. In conclusion, a reference range for UNGAL in VLBW infants, similar to that in children and adults, has been established.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 75%

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confidence: 99%

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Reference Values of Urinary Neutrophil Gelatinase-Associated Lipocalin in Very Low Birth Weight Infants

et al. 2009

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“…The results showed that, uNGAL levels in the current study were higher than the recently reported standard value in VLBW infants (15,25). This difference may be explained by the fact that there were many premature infants with a gestational age <27 weeks among our subjects.…”

Section: Discussioncontrasting

confidence: 78%

Urinary neutrophil gelatinase-associated lipocalin is an early predictor of acute kidney injury in premature infants

Kuribayashi

Suzumura

Sairenchi

et al. 2016

Experimental and Therapeutic Medicine

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Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is produced in response to tubular epithelial injury and is a biomarker of tubulointerstitial injury. The aim of the present study was to examine whether acute kidney injury (AKI) could be predicted by measuring uNGAL in very low-birth weight (VLBW) infants. Forty VLBW infants with birthweight below 1,500 g were enrolled in the present study. uNGAL and serum creatinine (sCre) were measured daily from postnatal days 0 to 8. Infants with sCre ≥1.2 mg/dl were diagnosed with AKI. The relationship of uNGAL with sCre was measured on the day after uNGAL measurement (next-day sCre) was examined. The results showed that 16 infants had sCre ≥1.2 mg/dl in this period. Logistic regression analysis revealed that uNGAL on postnatal days 2, 3, 4, 5 and 6 was correlated with next-day sCre (P<0.05). uNGAL corrected by urinary Cre (uCre) (uNGAL/uCre) was only correlated with an increase in next-day sCre on postnatal days 5 and 6 (P<0.05). For the logistic analysis, subjects with high and low uNGAL levels based on the median value for each day, uNGAL on postnatal days 2, 3 and 6 in the high uNGAL group was correlated with an increase in next-day sCre. Thus, AKI may be predicted by measuring uNGAL in VLBW infants. This measurement was non-invasive, and is potentially useful for the evaluation of renal function in VLBW infants.

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“…8,9), and its protein appeared in the urine and in the serum (5-to 500-fold increase) within hours of stimuli that typically cause acute kidney injury (AKI). Inductive stimuli included sepsis (10)(11)(12)(13)(14), ischemia-reperfusion injury (IR) (9,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), obstructive uropathy (28), nephrotoxins (15,(29)(30)(31)(32)(33), traumarhabdomyolysis (34), kidney graft injury (35,36), or a mixture of these maladies (37,38). Sepsis was a particularly strong stimulus for LCN2 expression.…”

Section: Introductionmentioning

confidence: 99%

α–Intercalated cells defend the urinary system from bacterial infection

Paragas¹,

Kulkarni²,

Werth³

et al. 2014

J. Clin. Invest.

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129

111

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α-Intercalated cells (A-ICs) within the collecting duct of the kidney are critical for acid-base homeostasis. Here, we have shown that A-ICs also serve as both sentinels and effectors in the defense against urinary infections. In a murine urinary tract infection model, A-ICs bound uropathogenic E. coli and responded by acidifying the urine and secreting the bacteriostatic protein lipocalin 2 (LCN2; also known as NGAL). A-IC-dependent LCN2 secretion required TLR4, as mice expressing an LPS-insensitive form of TLR4 expressed reduced levels of LCN2. The presence of LCN2 in urine was both necessary and sufficient to control the urinary tract infection through iron sequestration, even in the harsh condition of urine acidification. In mice lacking A-ICs, both urinary LCN2 and urinary acidification were reduced, and consequently bacterial clearance was limited. Together these results indicate that A-ICs, which are known to regulate acid-base metabolism, are also critical for urinary defense against pathogenic bacteria. They respond to both cystitis and pyelonephritis by delivering bacteriostatic chemical agents to the lower urinary system.

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Reference Range of Urinary Neutrophil Gelatinase-Associated Lipocalin in Very Low-Birth-Weight Infants: Preliminary Data

Cited by 20 publications

References 6 publications

Reference Values of Urinary Neutrophil Gelatinase-Associated Lipocalin in Very Low Birth Weight Infants

Reference Values of Urinary Neutrophil Gelatinase-Associated Lipocalin in Very Low Birth Weight Infants

Urinary neutrophil gelatinase-associated lipocalin is an early predictor of acute kidney injury in premature infants

α–Intercalated cells defend the urinary system from bacterial infection

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