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

Abstract

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.

Acute kidney injury in pediatrics: an overview focusing on pathophysiology

“…Considering the intrinsic limitations of currently used kidney biomarkers, which only get augmented after significant kidney damage, the search for new biomarkers has increased in the past two decades [57]. In this regard, studies have evaluated the urinary levels of tissue inhibitor of metalloproteinases 2 (TIMP-2), insulin-like growth factor binding protein 7 (IGFBP7) [108][109][110], liver fatty-acidbinding protein (L-FABP) [111,112], kidney injury molecule-1 (KIM-1) [113,114], neutrophil gelatinaseassociated lipocalin (NGAL) [115][116][117], and interleukin (IL)-18 [118,119] and the capacity of these molecules to show early increases in response to kidney damage. In 2014, the United States Food and Drug Administration approved the use of TIMP-2/IGFBP7, known commercially as NephroCheck, as a diagnostic tool for AKI [56].…”

Potential Biomarkers in Diagnosis of Renal Acanthamoebiasis

“…Therefore, NGAL is considered to be a good renal biomarker involved in the pathophysiological process of acute kidney injury (AKI) [ 22 ]. Moreover, NGAL may be an indicator of renal ischemia associated with tubular necrosis, renal failure after renal transplantation, and chronic renal failure [ 23 ].…”

Impact of Pneumoperitoneum on the Post-Operative Renal Function and Level of Acute Kidney Injury Markers: Comparison between Laparoscopic and Open Nephrectomy

“…NGAL is produced in the granules of activated neutrophils and also by the nephron in response to any damage to tubular epithelium; therefore, NGAL can serve as a biomarker for tubulointerstitial injury. During renal injury, NGAL is mainly produced in the ascending thick limb of the loop of Henle and renal collecting tubule, and is immediately secreted into urine, which makes it a suitable biomarker for the prediction of renal failure [9].…”