Neonatology Fellow McGovern Medical School at the University of Texas Health Science Center at Houston Houston, Texas, United States
Background: Acute kidney injury (AKI) is common in preterm neonates and associated with adverse outcomes, including chronic kidney disease and mortality, that can be mitigated with early detection. Diagnosis of AKI relies on serum creatinine (SCr) which has limitations due to its delayed response, initial levels reflecting maternal SCr, and the volume of blood required for the assay in small neonates. While urinary biomarkers are useful early predictors of AKI in more mature neonates, there are limited data on the utility of these urine biomarkers in infants born < 25 weeks’ gestation. Objective: To determine the validity of two urinary biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) and epidermal growth factor (EGF), in predicting AKI in infants < 25 weeks’ gestation. Design/Methods: This prospective case-cohort study includes infants < 25 weeks’ gestation. We are collecting stored urine samples and SCr for all infants born < 25 weeks’ gestation in a large tertiary neonatal intensive care unit for the first postnatal week. Infants who are outborn, or those with major congenital anomalies or a genetic syndrome are excluded. All subjects are followed to determine the development of AKI in the first week, using the neonatal modified Kidney Disease Improving Global Outcomes (KDIGO) criteria. We will describe the incidence of AKI in this population. Fischer’s exact test and t-tests will be used to test the differences in urinary biomarkers and the baseline covariates comparing cases (AKI) and controls (non-AKI). IRB approval has been obtained. We have currently enrolled 21 patients and will complete the study in January 2024.
