The Tubular Damage Markers: Neutrophil Gelatinase-Associated Lipocalin and Kidney Injury Molecule-1 in Newborns with Intrauterine Growth Restriction

Abstract

Background: Intrauterine growth restriction (IUGR) is a poorly understood complication of pregnancy. It may be associated with various diseases in adulthood, such as hypertension, cardiovascular disease, insulin resistance, and end-stage renal disease. Objectives: The aim of this study was to check whether IUGR affects the function of renal tubules, as assessed by the tubular damage markers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1 (KIM-1). Methods: The study included 126 term neonates. Thirty-eight newborns were the result of pregnancies complicated by IUGR. Eighty-eight healthy newborns were the result of normal pregnancies with no prenatal or perinatal complications. The concentrations of urinary NGAL and KIM-1 were determined with a commercially available ELISA kit and were normalized for urinary creatinine (Cr) concentration. Results: We found a significantly higher urinary concentration of NGAL and NGAL/Cr ratio in newborns from pregnancies complicated by IUGR when compared to the reference group. We found that female gender was associated with a higher concentration of urinary NGAL and also urinary NGAL/Cr. Conclusions: This is the first work that demonstrates that urinary NGAL concentration and urinary NGAL/Cr are significantly higher in infants that are small for gestational age than in appropriate-for-gestational-age infants. This might indicate subclinical kidney damage in newborns with IUGR.

Serum KIM-1, NGAL, and NAG Levels and Correlation with the Diagnostic Value in Patients with Fracture Traumatic Shock

“…This may be due to renal injury following traumatic shock in patients with fractures, which caused varying degrees of damage to renal tubular epithelial cells and stimulated massive expression of KIM-1 in renal tubular epithelial cells. The extracellular region of KIM-1 can be cleaved into soluble fragments and excreted into urine by the action of proteases and can be stabilized in a neutral environment in vitro [ 14 , 15 ]. When traumatic shock occurs, the expression of NGAL in organs such as the lungs, liver, and immune cells is heavily upregulated, which can lead to increased serum NGAL levels.…”

Malondialdehyde and Neutrophil Gelatinase-Associated Lipocalin as Markers of Oxidative Stress in Small for Gestational Age Newborns from Hypertensive and Preeclamptic Pregnancies

“…Furthermore, intrauterine growth restriction seems to be related to underdeveloped kidneys with fewer functional nephrons, immature tubules, and abnormal glomeruli morphology which reduces kidney sufficiency. Such impairments of renal function, secondary to injury caused by hypoperfusion and oxidative stress, may negatively affect its hemodynamics, resulting in acute kidney injury, which correlates with higher morbidity and mortality rates later in life [25][26][27][28]. In our study, newborns from pregnancies complicated by preeclampsia and hypertension, including SGA, had significantly higher levels of NGAL both in the umbilical cord and in the first 12 hours of life.…”

The functional state of the kidneys in newborns with intrauterine delay development

“…Анализ мочевой концентрации NGAL в отличие от данных тех же авторов (Monika Kamianowska et al ) показал, что данный показатель на 1-3 сутки жизни достоверно выше в подгруппе новорожденных, соответствующих гестационному возрасту в группе доношенных новорожденных, что по-видимому обусловлено зрелостью иммунной системы и адекватностью воспалительных реакции в ответ на перинатальный стресс ( Таб. 2) [4]. В противоположность доношенным в обеих подгруппах недоношенных новорожденных достоверно высокие значения NGAL выявлены у новорожденных с ЗВУР.…”

“…При оценке состояния почек у новорожденных малых к гестационному возрасту установлено, что концентрация KIM-1 в этой подгруппе новорожденных на первые сутки жизни недостоверно превышает показатель подгруппы новорожденных, соответствующих гестационному возрасту. (Таблица 1 [4] Во 2-ой и 3-ей группе уровень этого маркера в МГВ подгруппе, несмотря на некоторое снижение в динамике раннего неонатального периода недостоверно превышает таковой в СГВ подгруппе, как при 1-ом, так и при 2-ом измерении.…”