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. 2011 Dec;159(6):907-12.e1.
doi: 10.1016/j.jpeds.2011.05.045. Epub 2011 Jul 23.

Urine biomarkers predict acute kidney injury and mortality in very low birth weight infants

David J Askenazi  1 , Angela Montesanti, Hayden Hundley, Rajesh Koralkar, Pushkar Pawar, Faisal Shuaib, Amandiy Liwo, Prasad Devarajan, Namasivayam Ambalavanan
Affiliations

Urine biomarkers predict acute kidney injury and mortality in very low birth weight infants

David J Askenazi et al. J Pediatr. 2011 Dec.

Abstract

Objectives: To test the hypothesis that noninvasive urinary biomarkers may improve early identification, differentiate causes, and predict outcomes of acute kidney injury (AKI) in very low birth weight subjects.

Study design: We performed 2 nested case-control studies to compare the ability of 6 urine biomarkers to predict AKI (rise in serum creatinine of at least 0.3 mg/dL) and mortality (death before 36 weeks postmenstrual age).

Results: Compared to subjects without AKI (n = 21), those with AKI (n = 9) had higher maximum neutrophil gelatinase-associated lipocalin (OR = 1.2 [1.0, 1.6]; P < .01; receiver operator characteristics [ROC] area under the curve [AUC] = .80) and higher maximum osteopontin (OR = 3.2 [1.5, 9.9]; P < .01; ROC AUC = 0.83). Compared with survivors (n = 100), nonsurvivors (n = 23) had higher maximum kidney injury molecule 1 (OR = 1.1 [1.0, 1.2]; P < .02; ROC AUC = 0.64) and higher maximum osteopontin (OR = 1.8 (1.2, 2.7); P < .001; AUC of ROC = 0.78). The combination of biomarkers improved predictability for both AKI and mortality. Controlling for gestational age and birth weight did not affect results considerably.

Conclusions: Urinary biomarkers can predict AKI and mortality in very low birth weight infants independent of gestational age and birth weight.

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Conflict of interest statement

statement None of the other authors have any conflicts of interest to declare for this study.

Figures

Figure 1
Figure 1
ROC AUC for NGAL, OPN, and both NGAL and OPN: their predictive abilities to detect AKI in very-low-birth-weight premature infants.
Figure 2
Figure 2
ROC AUC for KIM-1, OPN, and both KIM-1 and OPN: their predictive abilities to detect mortality in very-low-birth-weight premature infants.
See this image and copyright information in PMC

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