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Urine biomarkers for monitoring acute kidney injury in premature infants

Kidney Research and Clinical Practice 2020년 39권 3호 p.284 ~ 294
안요한, 이주영, 전지영, 전용훈, 성태정,
소속 상세정보
안요한 ( Ahn Yo-Han ) - Hallym University Kangnam Sacred Heart Hospital Department of Pediatrics
이주영 ( Lee Ju-Young ) - Inha University Hospital Department of Pediatrics
전지영 ( Chun Ji-Young ) - Hallym University Kangnam Sacred Heart Hospital Department of Pediatrics
전용훈 ( Jun Yong-Hoon ) - Inha University Hospital Department of Pediatrics
성태정 ( Sung Tae-Jung ) - Hallym University Kangnam Sacred Heart Hospital Department of Pediatrics

Abstract


Background: Premature infants are at high risk for acute kidney injury (AKI). Serum creatinine (Cr) has limitations for evaluating kidney function in premature infants. We evaluated whether urine biomarkers could be used to monitor AKI in premature infants.

Methods: A prospective cohort study was conducted among infants born at < 37 weeks. Urine biomarkers and serum Cr were measured on postnatal days 1, 3, 5, 7, 10, and 14. Infants were divided into 3 groups according to gestational age (GA); < 28, 28 to < 32 and 32 to < 37 weeks.

Results: AKI occurred in 17 of 83 (20.5%) recruited infants at a median age of 7 (interquartile range 5?10) days. While the most common cause of AKI was hemodynamically significant patent ductus arteriosus (53.8%) in infants of GA < 28 weeks, necrotizing enterocolitis was the leading cause (50.0%) in infants of GA 28 to < 32 weeks. Urinary levels of neutrophil-gelatinase-associated lipocalin/Cr were higher and epidermal growth factor/Cr were lower in AKI group before the onset of AKI in infants of GA < 28 weeks. In infants of GA 28 to < 32 weeks, urinary interleukin-8/Cr levels were higher in AKI group at approximately the time of AKI onset.

Conclusion: Several urine biomarkers were significantly different between AKI and no AKI groups, and some had changed before the onset of AKI. These groups were distinct according to causative factors of AKI and GA. Urine biomarkers could be useful for monitoring the development of AKI in premature infants.

키워드

Acute kidney injury; Biomarker; Gestational age; Premature infants; Urine

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