Abstract: FR-PO715
Urinary Neutrophil Gelatinase-Associated Lipocalin in Preterm Neonates
Session Information
- Pediatric Nephrology - 1
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Asdell, Nicole, Nationwide Children's Hospital, Columbus, Ohio, United States
- Mohamed, Tahagod, Nationwide Children's Hospital, Columbus, Ohio, United States
- Joshi, Shivam, The Ohio State University, Columbus, Ohio, United States
- Bonachea, Elizabeth, Nationwide Children's Hospital, Columbus, Ohio, United States
- Slaughter, Jonathan L., Nationwide Children's Hospital, Columbus, Ohio, United States
Background
Acute kidney injury (AKI) is common in hospitalized preterm neonates. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a promising noninvasive biomarker for detection of AKI. However, normal values of uNGAL in preterm neonates without AKI are poorly characterized limiting its’ clinical utility in this population.
Methods
Neonates born < 32 weeks GA admitted to our level IV NICU who didn’t have AKI, UTI, NEC, or sepsis were included. Urine was collected in the first postnatal week (n=100) and patients were categorized to 3 GA groups (23-25, 26-28, 29-31 weeks). uNGAL and urine creatinine (uCr) concentrations were evaluated using immunoturbidimetry and an enzymatic assay respectively. The Chi-squared test was used to examine the association between categorical variables and GA groups, while the Kruskal-Wallis rank sum test and ANOVA were used to identify differences in the distribution of continuous variables across GA groups. Pearson’s correlation assessed the relationship between GA and uNGAL and GA and the uNGAL/uCr ratio. Statistical significance was determined at an alpha level of 0.05.
Results
The median uNGAL for infants born 23-25, 26-28, and 29-31 weeks were 653, 205, and 78 ng/dL respectively. Similarly, the uNGAL/uCr ratios at these GA were 62,19, and 7.9 ng/dL respectfully. Baseline concentrations of both uNGAL (R=-0.606, p<0.001 ) and uNGAL/uCr (R=-0503, p= <0.0001) decreased as GA increased.
Conclusion
Baseline urinary NGAL levels were shown to be elevated in preterm neonates. NGAL is present in the urine as early as 23 weeks gestation and its' concentration decreases with increasing gestational age.
uNGAL by GA
| Variable | N | Overall N=100 | 23-25 weeks N=23 | 26-28 weeks N=36 | 29-31 weeks N=41 | P-Value | Metrics | |
| Sex | F M | 100 | 40 (40%) 60 (60%) | 8 (34.78%) 15 (65.22%) | 13 (36.11%) 23 (63.89%) | 19 (46.34%) 22 (56.66%) | 0.556 | N (%) N (%) |
| Urine Creatinine | 100 | 10.65 (6.9,15.8) | 7.1 (4.6,10.9) | 11.5 (6.85,16.05) | 11.6 (9,16.1) | 0.038 | Median (Q1, Q3) | |
| Urine NGAL | 100 | 178 (73,428.5) | 653 (210,1034) | 205 (93,323) | 78 (42,252) | <.001 | Median (Q1,Q3) | |
| BW (g) | 100 | 1129.88 (341.60) | 729.26 (126.07) | 1058.61 (203.69) | 1417.20 (249.58) | <.001 | Mean (SD) | |
| Urine NGAL/Urine Creatinine | 100 | 17.49 (6.36,50.58) | 61.52 (37.10,118.93) | 18.51 (7.67,35.94) | 7.86 (4.00,16.39) | <.001 | Median (Q1, Q3) |
Funding
- Private Foundation Support